UC-NRLF 


B 


TO  THE 


LIBRARY  OF  THE 
MEDICAL  DEPARTMENT 

OF  THE 
UNIVERSITY  OF  CALIFORNIA 


£2*          >* 


LI- 
SENSATION 


BY 


CHARLES  FAYETTE  TAYLOR,  M.D. 


A    LECTURE  DELIVERED   BEFORE    THE  NEW   YORK  ACADEMY 

OF  SCIENCES,  MARCH  zist,   1881;  BEING   ONE  OF 

THE  PUBLIC  COURSE  FOR  i88o-Bi. 


NEW  YORK 

G.    P.    PUTNAM'S    SONS 

27  AND  29  WEST  23d  STREET 

1881 


COPYRIGHT,  1881,  BY  G.  P.  PUTNAM'S  SONS. 


Press  of 

P.  Putnam's  Sons 
New  York 


0\v 


; 


422 


SENSATION   AND   PAIN. 


THE  limits  of  a  single  lecture  are  too  small  to 
give  any  adequate  idea  of  the  complicated  struct- 
ures and  processes  by  which  we  experience  what 
we  call  sensation  and  pain.  But  my  primary  ob- 
ject being  to  obtain  some  practical  deductions 
from  certain  basic  facts  connected  with  the  phe- 
nomena of  sensation  and  pain,  rather  than  to  en- 
tertain you  with  a  detailed  exposition  of  the  subject, 
I  must  beg  your  attention  while  I  give,  as  necessary 
to  a  proper  understanding  of  conclusions  which  will 
be  ultimately  arrived  at,  a  brief  outline  of  some  of 
the  main  and  primary  facts  of  nerve-structure  and 
nervous  action.  In  doing  this,  I  shall  not  enter 
any  debatable  ground,  as  between  physiologists  and 
metaphysicians,  but  shall  simply  lead  you  a  little 
^vav  over  a  very  common  road. 


2  SENSATION  AND    i. 

You  will  see,  in  Fig.  I,  an  ideal  illustration  of  the 
simplest  form  of  a  nervous  system,  as  it  appears  to 
have  been  actually  differentiated;  whether  "evolved," 
one  order  from  the  preceding,  or  specially  created, 
one  order  after  another,  it  is  not  necessary  to  our 
present  purpose  to  inquire.  It  consists  of  a  nerve- 
'  tract  passing  from  without  inwardly  where  it  joins 
a  highly  endowed  structure  called  a  nen-e-centre. 
And  from  this  so-called  nerve-centre  there  goes 
another  nerve-tract  which  proceeds  outwardly  to 
some  structure  which  is  to  be  excited  to  action. 

FIG.  I. 


B 


If  A,  in  the  figure  A,  B,  C,  (Fig.  i)  be  touched, 
an  impulse  is  produced  which  is  conveyed  along  the 
nerve-tract,  A,  B,  to  the  nerve-centre.  B.  where  a  re- 


SEXSATION  AND    PAIN.  3 

markable  thing  happens:  the  impulse  of  the  touch 
causes  a  change  to  take  place  in  the  highly  un- 
stable substance  of  the  nerve-centre,  which  so  mod- 
ifies it,  that  one  of  another  quality  is  sent  out 
along  the  nerve  which  proceeds  from  the  centre 
and  it  becomes  now  a  motor  impulse — or  an  impulse 
which  causes  the  organ  to  which  it  proceeds  to  act: 
if  a  muscle  to  contract;  if  a  gland  to  secrete,  etc. 
Speaking  generally,  there  can  be  no  functional  ac- 
tion of  any  organ  without  an  appropriate  supply  of 
nervous  stimulus.  But  the  nervous  stimulus  thus 
supplied,  is  what  is  denominated  reflex;  that  is,  it 
proceeds  from  an  impulse  set  up  by  external  agency, 
is  transmitted  to  the  nerve-centre,  inducing  there  a 
disturbance  of  such  a  nature  that  a  motor  impulse  is 
sent  off  along  a  nerve  proceeding  from  the  centre, 
with  the  effect  of  causing  some  kind  of  action  in  the 
organ  to  which  it  goes. 

In  this  ideal  illustration  of  the  plan  of  nervous 
action,  I  have  supposed,  for  the  more  easy  compre- 
hension of  the  subject,  but  a  single  nerve-fibre  as 
a  nerve-tract,  and  a  single  cell  as  a  nerve-centre.  In 
reality  there  are  many  nerve-fibres  in  every  nerve- 
tract,  and  many  nerve-cells  entering  into  the  struct- 
ure of  every  nerve-centre ;  in  fact,  vast  numbers  of  them 
go  to  make  up  a  very  small  centre  of  nervous  force. 


SENSATION  AND    PAIN. 


FIG.  2. 


Nervous  System  of  the  Ascidian. 
[FROM  CARPENTER'S  MENTAL  PHYSIOLOGY.] 


The  next  figure  (Fig.  2)  represents  the  nervous 
system  of  the  Ascidian.  There  is  a  single  nerve- 
centre  with  two  or  three  pairs  of  nerves  communi- 
cating with  the  mouth,  vent  and  body  of  the  crea- 
ture. Now  if  these  nerve-tracts  be  straightened 
out,  we  should  have  an  arrangement  of  the  nervous 
system  almost  as  simple  as  the  ideal  one  represented 
in  figure  I. 

Here  (Fig.  3)  are  several  nerve-cells,  highly  mag- 
nified, and  their  intimate  relations  through  connect- 
ing fibres  are  also  to  be  seen.  It  is  this  arrange- 
ment of  sensitive  nerves  to  carry  an  impulse  inward, 
and  of  nerve-centres  to  receive  and  evolve  energy, 


SENSATION  AND  PAIN. 
FIG.  3. 


Nerve   Cells — Gray  Matter — Magnified. 
[FROM  DALTON'S  PHYSIOLOGY — DEAN.] 

independently    of    consciousness    and    will,    which 
makes  life  possible. 

Neither  man  nor  the  lower  orders  of  creatures  could 
exist  except  for  the  constantly  acting  agency  of  reflex 
nervous  action.  A  single  example  will  sufficiently 
illustrate  reflex  nervous  action  in  the  lower  orders. 


SENSATION  AND    PAIN. 
Fig.  4. 


Nervous  System  of  the  Centipede. 
[FROM  CARPENTER'S  MENTAL  PHYSIOLOGY.] 

In  the  nervous  system  of  the  centipede  (Fig.  4) 
we  find  a  series  of  nerve-centres  corresponding  with 
each  pair  of  its  many  legs.  The  touch  of  the  feet 
upon  the  floor  creates  a  sensory  impulse  which,  be- 
ing transmitted  to  the  corresponding  nerve-centre, 
throws  the  unstable  material  of  which  it  is  composed 


SENSATION  AND    PAIN.  7 

into  excitement  and  change,  during  which  a  motor 
impulse  is  developed  which  is  conveyed  back  to  the 
muscles  of  the  legs  and  they  are  thus,  each  time, 
successively  and  renewedly  set  in  motion  by  their 
own  impress  upon  the  ground,  without  the  aid  of 
consciousness  and  volition.  For,  let  this  creature 
run  over  the  table  and,  while  at  full  speed,  snip  off 
his  head  with  the  scissors  and  he  will  continue  to 
run,  apparently  as  well  as  before,  until  he  meets 
with,  an  obstacle. 

I  said  that  animal  life  could  not  exist  without  the 
part  played  by  reflex  nervous  action.  This  is  just 
as  true  of  the  higher  Mammalia  and  Man  as  of  the 
centipede  or  the  jelly  fish. 

In  the  next  figure  (Fig.  5)  you  may  see  a  magnified 
representation  of  a  transverse  section  of  the  human 
spinal  cord.  The  spinal  cord  may  be  considered  as 
a  prolongation  downwards  of  the  brain,  with  which 
it  is  most  intimately  connected.  It  is  composed  of 
two  parts;  the  inner  or  gray  portion  is  the  seat  of  the 
nerve-centres  for  each  pair  of  nerves  which  are  sent 
off  at  every  vertebra.  The  external  or  white  portion 
is  composed,  principally,  of  conducting  nerve-fibres 
for  the  transmission  of  nervous  impulses  in  both  di- 
rections. The  internal  or  gray  portion  is  made 
up  of  the  highly  endowed,  exceedingly  unstable 
nerve-cells,  constituting  "  nerve-centres,"  which 
under  stimuli,  have  the  faculty  of  transforming 


SENSATION  AND    PAIN.       . 

sensory    impulses    into    motor    impulses   as   before 
mentioned. 


FIG.  5. 


Transverse  Section  of  Human  Spinal  Cord. 
[FROM  DALTON'S  HUMAN  PHYSIOLOGY.] 

Although  the  spinal  cord  of  the  higher  vertebrates 
is  not  anatomically  separated  into  distinct  gangli- 
onic  bulbs,  as  is  seen  in  that  of  the  centipede,  the 
reflex  function  is  not  less;  but  the  relation  between 
the  different  nerve-centres  is  rendered  immensely 
greater  and  more  intimate  by  the  great  multitude 
of  connecting  nerve-fibres.  When  we  speak  of  sen- 


SENSATION  AND    PAIN.  9 

sory  and  motor  nerves,  we  mean  entirely  distinct 
nerve-fibres  which  pass  from  without  to  the  centre 
and  which  pass  from  the  centre  outward  to  all  the 
organs.  These  different  tracts  of  different  nerves 
with  different  offices  to  perform,  have  names  given 
to  them  according  to  their  respective  offices.  The 
sensory  is  as  often  called  the  afferent  nerve  because 
it  transmits  the  impulse  originating  externally  in 
reference  to  the  centre,  towards  the  centre;  and 
the  motor  is  as  often  called  the  efferent  nerve  be- 
cause it  conveys  the  motor  energy  developed  in  the 
nerve-centre  outwardly  toward  the  organ  to  be  ex- 
cited to  action.  The  sensory  or  afferent  nerves  en- 
ter the  spinal  cord  behind  and  communicate  directly 
with  the  gray  matter;  and  the  anterior  or  motor 
fibres  arise  in  the  gray  matter  and  pass  out  in  front. 
But  the  anterior  and  posterior  portions  (or  ''roots") 
soon  unite  and  form  one  nervous  tract  in  their  dis- 
tribution throughout  the  body.  But  the  ultimate 
nerve-fibres  are  kept  entirely  distinct  throughout 
their  distribution.  I  will  now  remark  that,  in  the 
diagram  first  shown,  the  tracts  of  the  sensory  and 
motor  nerves  were  figured  distinct  from  each  other 
for  the  purpose  of  greater  definiteness  in  presenting 
the  ideas  of  afferent  and  efferent  nerve-tracts.  They 
are,  in  reality,  bound  up  in  the  same  bundle  imme- 
diately after  leaving  the  spinal  cord. 

Thus  we  have  the  three  elements  co-operating"  in 


10  SENSATION  AND    PAIN. 

the  production  of  every  physiological  act;  the  sen- 
sory nerve  to  convey  inwardly  an  impulse  set  in  mo- 
tion by  external  causes;  the  nerve-centre  excited 
to  active  change  by  the  stimulus  received,  and 
the  motor  nerve  to  transmit  the  energy  gener- 
ated in  the  nerve-centre  to  the  destined  organ, 
which,  in  its  turn  is  excited  to  action.  The  plan 
of  nervous  action  is  simple  enough  when  thus 
analyzed. 

I  wish  now  to  call  your  attention  to  the  important 
fact  that  all  nervous  action  consists  of  pulses,  throbs, 
ebullitions  or  explosions  of  nervous  energy,  accord- 
ing to  the  degree  of  action.  There  is  a  rising  under 
sensory  stimulus,  a  pulse  of  excitement,  and  a  dis- 
charge of  energy,  and  then  a  subsidence,  followed  by 
never-ending  quiescence,  unless  the  centre  is  again 
stimulated  from  some  source  external  to  itself.  It 
is  important  that  this  fact — the  pulse  and  subsidence 
of  activity  in  the  nerve-centre — should  be  kept  in 
mind,  because  it  is  one  of  the  basic  facts  of  sensa- 
tion and,  in  fact,  of  all  nervous  phenomena.  The 
pulse  of  activity  in  a  nerve-centre  under  a  sensory 
stimulus,  during  which  a  motor  impulse  is  generated, 
may  be  illustrated,  perhaps,  in  a  crude  way,  by  com- 
parison with  the  Geysers  or  "Spouting  Springs,"  so 
far  as  the  periodical  exhibition  of  force,  depending 
on  exciting  causes  and  determining  conditions,  may 
serve  to  illustrate.  As  in  the  Geysers,  there  would 


SENSATION  AND    PAIN.  II 

be  no  activity  of  the  waters  except  there  was  a  flow- 
ing in  from  surrounding  media,  an  accumulation  of 
heat,  steam  and  pressure,  a  throb  of  uncontainable 
forces  and  a  belching  forth  of  the  waters,  fol- 
lowed by  subsidence  until  the  same  conditions 
recur;  so  the  nerve-centres  never  act  except  un- 
der the  compulsion  of  sensory  stimulation,  and 
the  different  organs  of  the  body  would  be  forever 
dormant  except  for  the  energy  developed  in  the 
nerve-centres  which  sets  their  dormant  powers  into 
action. 

Thus  we  see  the  fundamental  part  which  sen- 
sation plays  in  animate  beings.  In  fact  the  term 
"  sentient  beings"  is  often  employed  as  synon- 
ymous with  animal  life. 

But  while  we  have  been  speaking  of  "  sensory 
impulses,"  we  have  not  yet  reached  conscious  sen- 
sation. Let  us  proceed  a  step  further  in  our  in- 
vestigations. Referring  again  to  our  diagram  rep- 
resenting the  nervous  system  of  the  centipede 
(Fig.  4),  we  see  a  succession  of  ganglia,  or  little 
brains,  connected  together  by  slender  nervous 
fibres  and  terminating  in  one  ganglion  which 
throws  out  prolongations,  not  to  a  pair  of  legs 
but  to  a  pair  of  end  organs,  namely,  a  pair  of 
eyes.  That  is,  the  branches  of  the  anterior  gang- 
lion communicate  with  organs  more  highly  devel- 
oped than  are  the  feet.  Now  when  the  creature 


12  SENSATION  AND    PAIN. 

approaches  an  obstacle  or  an  enemy,  this  terminal 
ganglion  of  the  series  becomes  affected  and  sends 
back  an  inhibitory  impulse,  which,  according  to 
its  nature  and  degree,  either  modifies  the  auto- 
matic action,  as  before  described,  so  as  to  turn 
the  creature  to  one  side;  or,  perhaps,  arrests 
further  progress  by  entire  inhibition.  Other  lan- 
guage would  be  to  say  that  the  creature  sees  the 
obstacle  or  the  enemy  and  the  controlling  influ- 
ence of  the  more  highly  endowed  terminal  gang- 
lion is  set  up. 

Passing  at  a  single  step  from  those  simple  forms 
of  life  which  I  have  illustrated,  for  convenience,  by 
the  nervous  system  of  the  centipede,  (Fig.  4)  whose 
movements  are  directly  reflex,  or  reflex  modified 
by  the  inhibitions  of  more  highly  developed  "end 
organs"  or  eyes  and  their  specialized  ganglion, 
we  come  at  once  to  the  most  highly  differentiated 
and  endowed  nervous  system  of  all,  that  of  man. 
Referring  to  the  figure  (Fig.  6),  we  see,  that  in- 
stead of  a  series  of  bulbs,  with  a  terminal  bulb 
more  or  less  specialized,  we  have  a  mass,  anato- 
mically continuous,  and  terminating  in  a  structure 
so  enormously  expanded  as  to  be  properly  denom- 
inated the  "  central "  organ  of  the  whole  nervous 
system.  But  in  acquiring  continuity  of  structure, 
the  spinal  cord  has  lost  none  of  its  qualities  as  a 
series  of  nerve-centres. 


SENSATION  AND  PAIN. 
FIG.  6. 


Nervous  System  of  Man— Brain  and  Spinal  Cord. 
[FROM  ORTON'S  ZOOLOGY.] 

It  is  with  the  brain  as  a  central   nerve-organ — 
a  congeries  of  differentiated  and  highly  specialized 


14  SENSATION  AND    PAIN. 

nerve-centres,  a  nerve-centre  of  the  nerve-centres 
• — that  we  have  more  especially  to  do. 

I  have  used  the  simpler  forms  of  reflex  nervous 
action  as  illustrative  incidents  with  which  to  render 
more  clear  the  phenomena  of  all  nervous  action, — 
the  excitation  by  stimuli,  the  pulse  or  throb  or 
ebullition  or  explosion  of  energy,  according  to  the 
degree  of  stimulation  in  the  nerve-centre,  with 
the  discharge  of  a  motor  impulse  to  excite  action 
in  the  organ  to  which  it  is  sent, — in  order  that 
you  may  have  a  clear  conception  of  what  takes 
place  in. that  centre  of  centres,  the  brain  itself. 
For  the  brain  is  only  a  nerve-centre — with  ex- 
traordinary endowments,  and  of  immense  size,  to 
be  sure — but  it  is  a  nerve-centre  still.  And  it 
acts  only  as  it  is  incited  to  action  by  stimuli,  ex- 
actly the  same  as  the  simplest  nerve-centre  that 
controls  the  motions  of  an  ascidian  or  a  single 
pair  of  a  centipede's  legs.  But  with  this  differ- 
ence that,  whereas  the  simple  nerve-centres  of 
the  lower  orders  of  creatures  receive  impulses  from 
without  along  afferent  or  sensory  nerve-tracts, 
without  power  of  origination  of  sensory  impulses, 
the  brain  seems  to  have  this  power  of  central  self- 
stimulation.  In  other  language,  the  brain  seems 
to  be  capable  of  receiving  stimuli  from  two  direc- 
tions, viz.:  from  the  direction  of  the  body  and  the 
external  media,  through  the  senses,  and  also  from 


SENSATION  AND    PAIN.  15 

the  direction  of  that  unknown  and  unknowable 
something  which  we  denominate  the  Mind.  But, 
whether  the  stimulus  comes  from  the  direction 
of  the  various  senses,  or  from  that  of  the  mind, 
the  important  fact  remains  that  the  effect  pro- 
duced is  precisely  the  same  in  each  case.  The 
difference,  where  difference  exists,  is  one  of  de- 
gree, never  of  kind.  For,  instance,  the  thought 
of  a  friend  or  an  enemy  produces  the  same  kind 
of  throb  in  the  cerebral  centre  that  the  sight  of 
a  friend  or  an  enemy  produces.  The  thought  of 
food  causes  a  cerebral  pulse  which  produces  the 
same  sensations  as  the  sight  of  it,  differing  only 
in  degree.  It  is  these  centrally  originating  sen- 
sations which  we  are  more  particularly  to  study, 
in  our  consideration  of  sensation  and  pain,  in  this 
discussion. 

A  sensory  impulse — it  may  be  of  touch,  sight, 
taste,  hearing,  the  muscular  sense  or  that  of  hunger, 
no  matter  what,  provided  it  originates  outside  the 
sensorium — is  transmitted,  first  to  its  own  nerve- 
centres  on  its  way  to  the  sensorium,  producing  ev- 
erywhere its  own  appropriate  reflex  influences,  until 
finally  it  reaches  the  great  nerve-centre,  the  brain. 
Here  we  become  conscious  of  the  impulse  which  has 
been  transmitted  towards,  and  has  now  reached  the 
brain  only  through  the  pulse  or  throb  of  action  which 
has  been  produced  in  the  unstable  substance  of  the 


1 6  SENSATION  AND    PAIN. 

brain  nerve-cells  precisely  the  same  as  the  minor 
nerve-centres  respond  to  the  same  impulse,  on  its 
passage  to  the  brain.  And,  on  the  other  hand,  the 
same  changes  take  place  in  the  nerve-cells  when  the 
sensory  impulse  is  centrally  initiated,  as  when  it 
comes  from  without  this  centre.  So  that  the  brain 
as  a  centre  is  continually  subjected  to  the  double 
influence  of  peripheral  and  central  sensory  excita- 
tion. How  it  acts  under  these  two  and  diverse 
sources  of  sensory  impulse,  it  is  the  main  purpose 
of  this  essay  to  inquire. 

There  is  no  way  to  study  one  kind  of  nerve-centre 
stimulus  without  comparing  it  with  all  other  forms. 
Let  us  briefly  consider  how  we  become  conscious  of 
anything:  that  is,  how  an  ordinary  sensory  impulse 
becomes,  on  reaching  the  sensorium,  a  conscious 
sensation.  There  are  only  two  ways  by  which  a 
sensation  can  become  a  cognition — by  repetition  and 
by  comparison  with  other  sensations  of  different 
kinds  and  of  the  same  kind.  In  other  words,  by 
the  relations  of  differences.  We  are  incapable  of 
perceiving  anything  but  differences.  It  may  be  dif- 
ferences of  kind  or  of  degree  or  of  time.  But  there 
must  be  a  change  (or  difference)  in  one  or  more  of 
these  three  kinds  of  differences,  or  we  immediately 
cease  to  feel. 

It  is  the  law  of  nervous  action  that  a  sensation, 
once  transmitted,  is  more  easily  transmitted  along 


SENSATION  AND    PAIN.  17 

the  same  nerve-tract  and  more  readily  and  more 
deeply  affects  the  same  nerve-centres  afterwards ;  and 
in  proportion  as  the  same  sensation  is  repeated  over 
the  same  tract,  the  transmission  is  not  only  the  more 
easily  accomplished  but  all  the  reflex  influences  are 
similarly  facilitated.  Hence  dexterity  acquired  by 
practice  in  any  art  or  act — dexterity  being  but  an- 
other word  for  well-organized  reflexes — is  simply 
the  result  of  the  impressions  which  have  frequently 
passed  through  the  same  nerve-tracts  with  repeti- 
tions of  the  same  pulses  of  molecular  change  in 
the  same  nerve-centres.  At  last,  we  may  say,  the 
tract  has  been  made  and  worn  smooth  and  what 
is  called  a  " habit"  is  formed.  That  is,  there  has 
been  such  an  alteration  in  the  nervous  tracts  and 
in  the  nerve-centres  that  the  impression  has  become 
fixed  in  the  very  structures  of  the  nerves  themselves. 
This  is  memory  in  its  primitive  and  representative 
character.  In  walking  over  the  abyss  below  Nia- 
gara Falls  on  a  tight  rope,  Blondin  could  hardly  have 
fallen,  for  the  co-ordinated  memories  of  all  his  past 
experiences  so  controlled  his  movements  that  iU 
would  have  been  difficult  for  his  will  to  seriously 
interfere  with  his  reflexes. 

But  subjection  to  the  influence  of  sensations  which 
have  gone  before,  of  the  same  kind,  is  modified  by 
the  equally  important  influence  of  preceding  sensa- 
tions of  different  kinds.  The  effect  on  a  nerve-cen- 


1 8  SENSATION  AND    PAIN. 

tre,  of  a  touch  on  the  leaves  of  a  rose,  would  be 
represented  by  a  certain  quality  and  degree,  at  one 
moment;  but  the  changes  represented  by  the  pleas- 
urable sensation,  would  be  modified  if  not  entirely 
overcome  by  other  and  more  intense  activities  set 
up  by  the  pricking  of  a  finger  by  a  thorn  concealed 
among  the  leaves. 

It  must,  therefore,  be  remembered  that,  while  we 
may  assume,  for  the  purpose  of  simplifying  the  de- 
scription, that  there  are  simple  sensations,  such  sim- 
ple sensations  never  actually  occur.  The  most  that 
can  be  said  is  that  there  are  always  paramount  sen- 
sations— sensations  which  exert  a  paramount  influ- 
ence, momentary  or  prolonged,  over  the  changes 
which  are  always  pulsing  in  the  nerve-centres.  The 
prick  of  the  thorn,  in  the  preceding  illustration, 
causes  a  sensation  which  is  sufficient  to  displace  the 
ordinary  sensation  of  touch  on  the  rose  leaves.  A 
child  asleep  may  withdraw  the  hand  by  simple  re- 
flex action  when  a  fly  alights  on  it,  but  if  a  larger 
fly  alights  on  the  other  hand,  the  stronger  impres- 
,sion  made  by  the  larger  fly  will  cause  that  hand  to 
be  removed  while  the  lesser  sensation  will  remain 
unmanifested  in  reflex  action.  What  is  true  of  the 
simpler  reflex  action  of  the  smaller  nerve-centres  is 
equally  true  of  the  great  cerebral  nerve-centre. 
We  cannot  entertain  two  entire  sensory  impres- 
sions at  the  same  moment  of  time.  Either  one 


SENSATION  AND    PAIN.  19 

will  be  paramount  and  the  other  subordinate  or 
each  impression  will  be  diminished  so  that  their 
united  influence  will  only  equal  what  either  would 
be  alone.  The  same  is  as  true  of  painful  sensations 
as  of  ordinary  feelings.  A  man  with  both  legs 
broken  feels  pain  in  but  one  at  a  time.  I  remem- 
ber a  case  to  which  I  was  called  in  consultation  with 
the  late  Dr.  Peaslee,  where  a  lady,  while  in  the 
country,  had  dislocated  the  knee  joint.  After  a 
great  deal  of  suffering  she  was  finally  brought  to 
Dr.  Peaslee,  when  he  found  that  the  knee  had  not 
only  been  dislocated  but  the  bone  had  been  broken 
a  few  inches  below  the  knee.  The  pain  from  a  dis- 
located knee  had  been  so  much  greater  than  that 
from  the  simple  fracture  that  she  did  not  recognize 
any  pain  at  all  at  the  point  of  fracture.  The  same 
thing  takes  place  continually  with  reference  to  all 
our  sensations,  whether  of  pleasure  or  pain;  we  are 
only  conscious  of  what  may  be  the  paramount  in- 
fluence. But  it  must  not  be  supposed  that  what 
happens  to  be  the  paramount  impression,  whether 
on  the  simpler  nerve-centres  or  on  the  sensorium 
and  the  consciousness,  must  necessarily  arise  from  a 
cause  of  paramount  importance.  On  the  contrary, 
reflex  action,  as  well  as  consciousness,  depends 
so  largely  on  attention  and  habit  that  a  cause  of 
comparatively  little  importance  may  set  up  ac- 
tion in  the  nerve-centres  and  affect  consciousness  in 


20  SENSATION  AND    PAIN. 

a  manner  out  of  all  proper  proportion  to  its  real 
importance. 

The  effect  of  sensory  impressions  on  the  reflex 
actions  as  well  as  on  the  consciousness,  depends 
von  a  great  variety  of  interacting  causes;  so  that 
we  are  obliged  to  begin  a  successful  study  of  the 
phenomena  of  conscious  life,  by  distrusting  and  dis- 
counting the  evidence  of  our  senses  in  advance.  I 
mean,  of  course,  conclusions  drawn  from  mere  sen- 
sations. Alone,  they  are  not  evidence  of  anything; 
and,  without  support,  they  are  not  to  be  trusted  as 
sufficient  evidence  of  positive  facts.  The  rays  of 
light  reflected  from  a  luminous  body  fall  on  your 
retina.  A  sensory  impulse  is  produced  in  the  rods 
and  cones  of  the  eye  which  travels  back  to  the  sen- 
sorium  and  we  become  conscious  of  a  certain  sensa- 
tion. We  say  we  see  a  man.  That  is,  we  arrive  at 
the  visual  judgment  that,  at  a  certain  distance,  a 
man  is  standing.  The  combined  experience  of  all 
our  other  senses  and  of  many  years  use  of  the  visual 
sense  leads  us  to  conclude  that  a  man  is  there.  But 
if  the  same  size,  shape,  direction  and  intensity  of 
luminous  rays  had  never  fallen  on  the  retina  before; 
and  if  we  had  never  felt  the  shape  or  heard  the 
voice  of  a  man,  so  as  to  bring  to  our  aid  the  expe- 
rience derived  from  other  senses,  we  could  not  know 
that  the  luminous  object  represented  a  man.  The 
sensation  of  what  we  call  sight  would,  taken  alone 


SENSATION  AND    PAIN.  21 

and  without  the  corrections  of  experience,  be  quite 
insufficient  from  which  to  form  correct  ideas.  When 
we  say  we  "  see"  certain  objects,  we  mean  that  our 
visual  judgment  determines  that  such  an  object  is 
there.  Children  blind  with  congenital  cataract  il- 
lustrate the  imperfection  of  the  visual  sensation  and 
the  part  which  visual  judgments  play,  in  the  con- 
clusions drawn  from  the  sensations  caused  by  the 
luminous  rays  which  fall  on  the  retina  from  exter- 
nal objects.  When  sight  is  restored,  on  removal  of 
the  cataract,  the  patient  finds  himself  bewildered  by 
the  possession  of  sight.  He  cannot  judge  of  dis- 
tances, shapes  and  qualities  by  sight  alone,  but  must 
continually  supplement  vision  by  comparison  with 
other  senses,  which  have  already  furnished  him  ex- 
perience. He  cannot  tell  the  difference  in  the  shape 
of  a  disk  or  a  ball;  or  the  edge  of  a  disk  from  a 
straight  line.  The  relative  distances  of  objects  he 
gets  no  accurate  idea  of,  from  sight  alone,  and  he 
occupies  a  considerable  time  in  correcting  the  sen- 
sations yielded  by  his  eyes  by  using  the  other  senses, 
mainly  that  of  touch,  concerning  which  he  has  al- 
ready formed  actual  judgments,  or  experiences.  If 
one  of  us  had  never  seen,  and  should  suddenly  open 
his  eyes  and  behold  the  moon  for  the  first  time  he 
would  be  just  as  likely  to  reach  out  his  hand  to  grasp 
it  as  an  infant. 

It  may  assist  us  to  comprehend  the  mixed  and 


22  SENSATION  AND    PAIN. 

largely  subjective  nature  of  all  our  sensations,  to 
consider  how  impossible  it  is  to  be  otherwise.  What 
we  denominate  "seeing"  a  thing  is  made  up  of  many 
different  factors  and  is  not  the  simple  process  which, 
without  reflection,  it  might  seem  to  be.  First,  there 
is  an  impression  made  on  the  sensitive  structures  of 
the  retina  by  the  rays  of  light  coming  from  a  lumi- 
nous body,  but  this  light  has  been  a  certain  length 
of  time  in  coming.  If  from  the  sun,  nine  minutes 
nave  passed  since  the  rays  left  him.  Whatever  the 
distance,  it  is  certain  that  the  thing  seen  is  not  ex- 
actly the  same  that  it  was  when  the  rays  producing 
the  sensation  of'sight  left  it.  Light  leaving  the  near- 
est fixed  star  is  three  and  a  quarter  years  in  reach- 
ing the  earth.  So  that  in  case  that  star  had  suddenly 
gone  out  (something  which  has  happened),  we  should 
be  seeing  the  star  more  than  three  years  after  it  had 
ceased  to  exist.  Of  course  we  should  not  be  seeing 
the  star  when  it  did  not  exist.  •  It  is  only  that  cer- 
tain sensations  cause  the  visual  judgment  that  a  star 
is  there — a  judgment  which  is  more  than  three  years 
mistaken.  It  is  the  same  with  the  sensation  of  sound. 
We  do  not  hear  the  bell  ring  in  the  strict  sense  of 
that  term.  Sound  travels  at  the  rate  of  about  1,093 
feet  per  second;  so  that,  if  we  are  some  distance 
away,  the  vibrations  which  reach  the  ear,  at  any 
given  moment,  are  not  the  same  as  those  actually 
being  given  off  at  that  moment.  Nevertheless,  our 


SENSATION  AND    PAIN.  23 

accumulated  experience  enables  us  to  form  a  sense- 
judgment  concerning  the  substance  that  produces 
the  vibrations  in  the  air;  and  that  is  what  we  call 
hearing. 

But  it  also  requires  appreciable  time  for  the  sen- 
sations to  be  transmitted  along  the  afferent  nerves. 
It  requires  another  appreciable  length  of  time  for 
the  pulse  of  excitement  in  the  nerve-centre  to  take 
place,  and  it  requires  still  another  space  of  time  for 
the  motor  impulse  to  be  carried  to  its  appropriate 
organ.  Some  idea  of  the  element  of  time  may  be 
got,  perhaps  from  the  illustration  made  by  Mr. 
Richard  A.  Proctor,  in  a  lecture  which  I  heard, 
several  years  ago.  In  endeavoring  to  assist  his 
audience  to  a  conception  of  the  enormous  distance 
of  the  sun  from  the  earth,  he  used  this  illustration: 
he  said  that  if  a  child,  lying  in  his  cradle,  had  an 
arm  long  enough  to  reach  the  sun,  and  should  stretch 
it  out  and,  hitting  the  sun,  should  burn  his  finger,  it 
would  require  more  than  one  hundred  years  for  the 
sensation  to  reach  his  brain;  so  that,  to  use  an  Hi- 
bernianism,  reckoning  his  life  at  fourscore  years, 
he  would  have  been  dead  more  than  twenty  years 
before  he  would  know  he  had  been  burned.  The 
same  illustration  assists  our  conception  of  the  ap- 
preciable length  of  time  required  for  the  transmission 
of  sensation. 

According  to  Prof.  Dalton,  voluntary  motor  im- 


24  SENSATION  AND    PAIN. 

pulses  travel  through  the  spinal  cord  at  the  rate  of 
ten  metres  a  second;  while  they  travel  through  the 
spinal  nerves  at  the  rate  of  twenty -seven  metres  per 
second.  But  tactile  impressions  travel  at  the  rate 
of  forty -two  metres  a  second  through  the  spinal 
cord,  while  painful  impressions  are  transmitted  at 
the  rate  of  only  ten  metres  per  second.  The 
changes  which  take  place  in  the  brain  and  which 
accompany  the  act  of  perception,  also  occupy  an 
appreciable  length  of  time  for  their  accomplishment. 
Sensation  is  not  that  instantaneous  and  simple 
act  which,  without  a  certain  amount  of  positive 
knowledge,  it  might  seem;  it  is  a  very  complicated 
process. 

But  if  an  appreciable  length  of  time  is  required 
for  a  sensory  impression  to  become  a  conscious 
sensation,  a  considerably  longer  time  is  required  for 
such  a  sensation  to  pass  away.  The  sensory  ap- 
paratus, once  excited,  does  not  immediately  subside 
into  a  non^active  state,  but  the  pulse  or  wave  of 
molecular  change  which  has  been  set  up  in  the 
nerve-centres  remains  for  a  longer  or  shorter  time. 
A  lighted  match,  rapidly  revolved,  appears  like  a 
circle  of  fire  because  the  impression  made  by  the 
light,  while  at  a  certain  point,  does  not  subside 
before  the  luminous  object  is  back  again  at  the  same 
point.  Hence  we  say  we  see  a  circle  of  fire  although 
we  know  as  a  matter  of  fact,  that  it  is  a  point  of 


SENSATION   AND    PAIN.  25 

fire  which  we  see.  In  other  words,  our  sensations 
do  not  agree  with  our  knowledge.  So  we  do  not 
see  the  separate  spokes,  in  a  revolving  carriage 
wheel,  because  the  impression  made  by  one  does 
not  entirely  fade  away  before  another  has  been  made 
on  the  sense  of  sight.  There  are  several  familiar 
children's  toys  in  which  the  fact  of  the  lingering  of 
visual  sensations  is  taken  advantage  of.  One  con- 
sists of  figures  of  a  man  in  the  different  postures 
which  a  gymnast  assumes  in  leaping  through  a  hoop. 
These  are  printed  on  a  strip  of  paper  which  is  then 
wound  around  a  wheel  and  made  to  revolve  before 
the  eye  which  looks  through  a  hole.  One  figure 
follows  another  so  closely,  as  the  wheel  revolves, 
that  one  impression  has  not  faded  before  the  next  is 
made  and  instead  of  many  figures  in  different  posi- 
tions, there  seems  to  be  but  one  which  changes  its 
positions  as  if  it  were  alive  and  rapidly  leaping 
through  a  hoop.  But,  on  the  other  hand  a  wheel 
revolving  rapidly  in  the  dark,  appears  to  stand  still, 
with  every  spoke  distinctly  visible,  when  seen  by 
the  discharge  of  lightning  or  an  electric  spark. 
This  is  because  there  are  no  previous  sensations 
waiting  over  to  be  merged  with  those  that  follow. 
But  even  more  striking  cases  of  the  continuance  of 
visual  sensations  after  removal  of  the  luminous 
object,  are  those  numerous  instanceLa^wtHehr  every 
person  may  have  noticed,  wjjefef 

' 


? 


26  SENSATION   AND    PAIN. 

object  remains  for  a  considerable  time  and  of  a  dif- 
ferent color:  the  color  depending  on  that  of  the 
surrounding  objects.  These  are  called  "  after  im- 
ages." They  are  of  two  kinds;  positive  after-images 
and  negative  after-images.*  If  we  look  at  the  sun 
the  image  of  that  body  remains  for  a  long  time 
afterwards.  If  we  look  at  the  window  on  first  open- 
ing our  eyes  in  the  morning,  and  then  close  them, 
there  remains  an  image  of  the  window-sashes  and 
objects  near  it.  If  we  look  at  a  white  patch  on  a 
black  ground,  and  then  turn  the  eye  to  a  white 
ground,  we  see  a  gray  patch  for  a  little  time.  And 
a  black  patch  on  a  white  ground  gives  rise  to  an 
image  of  a  white  patch,  when  seen  and  the  eyes 
shut  immediately  afterwards.  So  also  when  a  red 
patch  is  looked  at,  the  negative  image  is  a  green- 
blue — the  complementary  color.  And  so  on,  with 
a  large  number  of  interesting  experiments.  It  is 
beyond  the  scope  of  this  lecture  to  enter  into  de- 
tailed explanations,  my  object  being  merely  to  state 
certain  facts  showing  the  inadequacy  of  ordinary 
sensation  to  give  us  correct  conceptions,  without 
the  aid  of  comparison  and  experience. 

We  have  the  visual  sensations  from  objects  mir- 
rored in  two  eyes  yet  perceive  only  one;  the  image, 
on  the  retina,  is  inverted,  yet  we  perceive  men  stand- 
ing on  their  feet  and  not  on  their  heads;  we  often  hear 

*  This  description  is  a  summary  from  Foster's  Physiology,  P.  551. 


SENSATION   AND    PAIN.  27 

sounds  as  if  coming  from  the  north  or  east  whereas 
they  actually  come  from  the  south  or  west;  we  think 
they  come  from  one  distance,  according  to  various 
judgment-reasons,  when  they  actually  come  from 
more  near  or  remote  distances  than  we  inferred 
from  the  volume  or  quality  of  the  sound;  Isaac's 
touch  was  not  delicate  enough  to  distinguish  be- 
tween the  goat's  hair  on  wily  Jacob's  hands  and 
hairy  Esau's  natural  covering;  I  knew  a  whole  family 
which  ate  horse-meat  steak  with  hearty  relish,  not 
knowing  it  by  taste  from  beef,  until  told,  when  their 
enjoyment  ceased  at  once.  The  sense  of  smell  does 
not  always  exist,  in  this  catarrhal  country,  and  when 
not  impaired,  this  sense  in  man,  is  the  least  reliable 
of  all.  What  we  know  of  the  distance,  size,  shape 
of  objects  is  only  suggested  by  the  rays  of  light 
emitted  or  reflected  and  subtending  certain  angles 
on  the  retina,  and  not  directly  imparted  by  what  we 
denominate  sight.  Mountains  appear  nearer  in  clear 
weather  because  we  can  then  see  objects  more  dis- 
tinctly; that  is,  with  better  defined  and  sharper 
outlines,  and  not  because  there  is  any  increase  in 
the  angles  of  light  coming  from  the  objects  and  out- 
lines of  the  landscape.  As  nearer  objects  are  usu- 
ally seen  more  easily,  when  we  can  see  objects 
clearly  which  are  obscure,  in  ordinary  states  of  the 
atmosphere,  we  say  they  are  not  so  far  away.  But 
when  we  have  had  no  experience,  or  when  there  is 


28  SENSATION  AND    PAIN. 

nothing  with  which  to  compare,  it  is  frequently 
astonishing  how  far  from  the  facts  our  sight  impres- 
sions are.  A  lady  in  my  family  said  she  saw  a 
meteor  fall  between  her  window  and  the  house  on 
the  other  side  of  the  street.  From  the  accounts 
afterwards  given,  the  estimates  of  observers,  at  differ- 
ent locations  and  distances,  placed  the  meteor  about 
forty  miles  away.  Every  one  knows  how  difficult  it 
is  to  form  accurate  conceptions  of  distances  at  sea  or 
concerning  objects  across  a  level  plain  the  breadth 
of  which  is  unknown.  Men  standing  beside  an  ob- 
ject which  is  taller  than  we  expect,  are  made  to  ap- 
pear shorter  than  they  are;  while  they  look  taller  if 
beside  an  object  which  is  less  high  than  we  had 
conceived  it  to  be. 

Indeed,  our  love  of  Art,  the  grand  and  the  beau- 
tiful, depends  largely  on  the  fact  that  many  things 
may  be  suggested  by  a  few.  A  few  properly  placed 
lines,  may  suggest  a  horse  or  a  sheep  or  a  mountain 
— as  witness  the  Japanese  constant  reproduction,  to 
the  mind,  of  their  sacred  mountain,  Fusiyama,  on  al- 
most all  their  works  of  Art,  by  about  three  or  four 
properly  placed  simple  lines.  A  picture  is  more  or 
less  perfect,  in  a  certain  sense,  according  as  the  artist 
has  the  power  of  making  his  work  suggest  more  than 
it  contains.  Caricature  depends  almost  entirely  on 
what  it  suggests  rather  than  on  what  it  contains. 
Hence,  a  caricature  can  never  be  an  artistically  fin- 


SENSATION  AND    PAIN.  29 

ishcd  picture.  And,  on  the  other  hand,  there  are 
many  artistically  finished  pictures  which  are  not 
suggestive  and  consequently  valueless,  because  they 
excite  in  the  mind  little  or  nothing  beyond  what  is 
actually  painted  in.  Many  a  bright  boy  in  school, 
wrestling  with  the  inspiration  of  mischief,  has  pro- 
duced, with  slate  and  pencil,  a  few  lines  containing 
whole  epics  of  suggestion  which  many  broad  can- 
vases of  labored  technique  fail  to  do. 

Yet,  without  the  several  senses  the  human  mind 
would  remain  a  blank  forever.  While  the  sense  of 
touch,  sight,  hearing,  taste  and  smell  impart  very 
little  directly  to  our  consciousness,  when  they  are 
repeated  millions  of  times  and  the  recorded  impres- 
sions are  compared  with  themselves  and  with  each 
other,  and  all  the  possible  combinations  with  them- 
selves and  with  each  other  are  raised  in  conscious- 
ness by  a  single  sensation,  there  is  established  a 
substantial  sub-structure  of  memory,  ideas  and  per- 
ception, the  arrangement,  development  and  proper 
exercise  of  which  constitutes  what  we  dominate 
culture.  We  thus  bring  under  observation  certain 
determinate  qualities  which  we  call  mind. 

Heretofore,  we  have  almost  exclusively  consid- 
ered sensation  as  coming  from  without  the  nerve- 
centres.  Rays  of  light  have  fallen  on  the  retina 
through  which  we  become  conscious  of  light  and 
shade;  we  reach  forth  our  hand  and  we  become 


30V  SENSATION  AND    PAIN. 

conscious  of  something  touched:  the  air  is  set  into 
vibratory  waves  which,  falling  on  the  ear,  give  us 
the  auditory  sensation;  particles  of  matter  floating 
in  the  air  come  in  contact  with  the  lining  mem- 
brane of  the  nasal  passages  and  we  have  the  sensa- 
tion of  smelling;  and  when  certain  other  particles 
of  matter  mingle  with  the  salivary  secretion  and 
buccal  mucus  we  have  the  sensation  of  taste.  We 
have  also  seen  how,  under  the  influence  of  com- 
parative and  multiplied  sensations,  the  nerve-centres 
become  modified  in  their  action,  so  that  after  awhile 
a  slight  sensory  impulse  is  sufficient  to  arouse  as 
much  action  as  a  stronger  one  could  do  at  first. 
So  that  sensations  become  practically  incorporated 
into  the  very  substance  of  nerve-structures.  And, 
finally,  that  with  the  infinite  connections  and  rela- 
tions of  sensations,  one  sensation  is  capable  of  call- 
ing up  other  and  not  directly  related  sensations,  or 
memories  of  past  sensations,  until  we  perceive,  in 
consciousness,  not  a  single  sensation  but  many  com- 
bined sensations  or  the  memories  of  sensations,  ris- 
ing to  the  stimulus  of  a  single  sensation.  Thus  the 
odor  from  the  kitchen  may  suggest  the  deer  which 
furnished  the  venison.  And  from  such  an  incite- 
ment, we  may  have  called  up  to  the  mental  conscious- 
ness, forests,  lakes  and  stalwart  hunters;  or,  perhaps, 
the  last  camp  on  the  mountain,  the  trout  in  the  lake, 
the  guide  and  his  dog.  But  it  is  not  necessary  that 


4IN. 


SENSATION  AND    PAIN.  31 

there  should  be  an  actual  peripheric  impulse,  trans- 
mitted through  an  afferent  nerve  to  the  sensorium, 
in  order  to  recall  or  re-excite  the  nerve-centres  to 
the  same  action  that  was  first  produced  by  the  sight, 
or  smell  or  hearing.  The  mind  acts  on  the  nerve- 
centres  the  same  as  external  objects  do.  When  we 
recall  the  face  of  a  friend,  the  picture  in  the  mind 
is  the  same  as  when  we  perceive  him  through  the 
sensation  caused  by  his  image  on  our  retina.  The 
image  called  up  in  memory  may  not  be  quite  as 
vivid,  but  the  difference  is  one  of  degree  only.  And 
it  may  happen,  even,  that  the  memory  is  the  more 
intense. 

These  centrally  initiated  sensory  impulses  will 
now  claim  our  attention.  The  subject  is,  in  my 
opinion,  one  of  vast  import  to  civilized  and  culti- 
vated people  and  I  beg  your  serious  attention  while 
I  briefly  unfold  my  meaning. 

I  cannot  better  make  clear  to  you  the  difference 
between  centrally  and  externally  excited  sensations 
than  by  relating  an  actual  occurrence.  A  young 
lady  friend  was  staying  with  one  of  my  daughters 
one  night,  when,  after  talking  a  long  while — as 
young  ladies  will  do — my  daughter  said,  "  Now  let 
us  stop  talking  and  go  to  sleep,  we  must  both  be 
asleep  in  three  minutes."  They  immediately  com- 
posed themselves  to  sleep.  After  a  couple  of  min- 
utes of  perfect  quietness,  my  daughter  exclaimed, 


32  SENSATION  AND    PAIN. 

"How  do  you  suppose  I  can  sleep  when  you  are 
counting  ?  "  She  says  she  heard  her  friend  count- 
ing with  perfect  distinctness.  Her  friend  replied: 
"I  am  not  counting  aloud."  After  a  little  dispute 
it  was  ascertained  that  the  young  lady  had  been 
counting  (as  is  often  done  to  assist  in  getting  to 
sleep)  but  counted  in  groups  of  tens,  with  pauses  be- 
tween each  group.  While  the  counting  which  my 
daughter  heard  was  straightforward  enumeration. 
So  it  was  certain  that  the  young  lady  had  not  un- 
consciously spoken  her  numbers,  which  my  daughter 
had  heard,  but  that  the  latter  had  unconsciously  in- 
itiated the  impulse  which  had  acted  on  her  nerve- 
centres  the  same  as  an  auditory  sensation  would 
have  done.  And  so  far  as  her  senses  could  inform 
her,  she  had  actually  heard  words  which  were  never 
spoken.  Except  for  the  circumstance  that  the  lady 
friend  was  counting  in  groups  of  numerals  with 
pauses  between  each  group,  either  of  two  explana- 
tions might  be  given,  neither  of  which  would  be 
true.  It  might  be  said  that  she  had  counted  aloud 
without  being  conscious  of  the  fact;  or  it  might  be 
called  a  case  of  so-called  mind-reading.  Whereas 
it  was  simply  one  of  those  numerous  cases  of  cen- 
trally initiated  sensations  which  cannot  be  dis- 
tinguished from  externally  excited  or  ordinary 
sensations.  While,  in  this  instance,  the  means  ex- 
isted for  correcting  the  error,  by  proving  that  my 


SENSATION  AND    PAIN. 


33 


daughter  could  not  possibly  have  heard  the  words 
which  she  perceived  distinctly  as  auditory  sensations, 
in  most  instances,  of  the  same  nature,  there  is  no 
direct  way  to  correct  the  mistake  as  to  the  source  of 
the  sensation.  Only  when  we  understand  how  fe.w 
and  imperfect  are  our  perceptions  which  come  di- 
rectly through  the  senses,  and  how  they  must 
be  continually  converted  into  judgment-sensations 
before  they  are  at  all  trustworthy,  can  we  com- 
prehend the  utterly  unreliable  character  of  sensa- 
tions and  impressions  which  arise  into  conscious- 
ness from  central  initiation.  In  fact,  a  large  portion 
of  our  lives  is  spent  in  being  deceived  by  our  senses; 
in  finding  the  mistakes  and  in  efforts  'towards  cor- 
recting them. 

Nothing  is  less  true  than  that  one  can  believe  the 
evidence  of  his  senses.  On  the  fact  that  we  ought 
not  so  to  believe  is  based  nearly  all  the  tricks  of  jug- 
glers, and  the  manifestations  of  mediums  and  clair- 
voyants, and  the  phenomena  of  the  trance  state. 
The  two  latter  apparitions  are  wholly  subjective 
conditions  (when  not  pure  deceptions)  and  the 
former  depends  almost  entirely  on  the  simplicity 
of  the  audience.  We  look  where  the  performer  de- 
sires us  to  look — to  engage  our  attention  is  his  stock 
in  trade — and  his  supposed  " tricks"  are  often  the 
most  ordinary  acts  done  under  our  very  eyes. 

Some  twenty  years  ago,  I  saw,  for  the  first  time, 


34  SENSATION  AND    PAIN. 

• 

the  then  renowned  wizard,  Anderson.  The  exhibi- 
tion made  a  great  impression  on  me.  How  was  it 
possible  for  him  to  do  all  those  wonderful  things  ? 
After  reflecting  some  days,  I  asked  myself,  "Did  he 
do  the  things  as  they  seemed  to  us?"  I  had  noticed 
that  he  had  a  great  deal  to  say  which  was  not  at  all 
relevant  to  the  performance — as  I  then  understood  it. 
I  have  since  learned  that  the  essential  part  of  a  jug- 
gler's skill  consists  in  a  judicious  use  of  apparently 
irrelevant  matter.  To  test  the  theory  which  I  had 
formed  that  a  juggler's  skill  consists  largely  in  the 
facility  with  which  an  audience  allows  its  atten- 
tion to  be  occupied  with  the  most  frivolous  things, 
while  changes  are  made  right  under  their  eyes,  I 
determined  to  attend  again,  this  time  to  look  ev- 
erywhere except  where  the  performer  seemed  to 
desire.  The  result  was  that  I  saw  that  a  large 
proportion  of  the  apparently  marvellous  tricks 
were  very  tame  transferrings  from  box  to  box 
and  place  to  place,  while  attention  was  kept  oc- 
cupied with  something  else.  This  discovery  made 
the  performance  very  tame  and  uninteresting,  and 
it  was  many  years  before  I  had  interest  enough 
to  see  another  of  a  similar  nature.  Heller's  tricks 
were  very  skilfully  done  and  they  contained  more 
that  was  collusive  with  his  assistants  —  as  the 
so-called  mind-reading — but  even  then,  any  one 
who  kept  his  wits  about  him  and  refused  to  allow 


SENSATION  AND    PAIN.  35 

his  attention  to  be  controlled  by  the  performer, 
could  see  that  nearly  everything  depended  on  the 
same  principle  of  not  seeing  anything  except  that 
which  is  presented  to  the  mind  by  the  performer. 

Many  things,  entirely  unnoticed  otherwise,  would 
be  plain  and  simple  enough,  when  one  kept  com- 
mand of  his  own  attention. 

Attention  plays  an  important  part  in  the  phe 
nomena  of  sensation  and  perception.  A  sensation 
which  would  pass  unnoticed  in  consciousness,  while 
the  attention  is  engaged  with  something  else,  be- 
comes apparent  so  soon  as  the  diversion  ceases.  So 
also,  the  same  sensation  which  is  barely  perceptible, 
to  the  unoccupied  consciousness,  may  become  acutely 
sensible  when  intense  expectation  is  aroused  regard- 
ing it. 

Because  \ve  are  not  conscious  of  having  seen  a 
reputed  occurrence,  is  not  sufficient  proof  that  the 
occurrence  did  not  happen  in  our  presence.  Several 
persons  witnessing  something  happening  in  the  street 
seldom  entirely  agree  as  to  what  actually  took  place. 
Divergence  immediately  arises  from  the  fact  that 
certain  parts  of  an  occurrence  make  stronger  im- 
pressions on  some  than  on  others;  and,  conse- 
quently more  completely  occupy  the  attention  to 
the  exclusion  of  other  acts  which  similarly  impress 
other  witnesses.  At  the  same  time,  the  persons 
witnessing  the  occurrence,  may  all  actually  see  the 


36  SENSATION  AND    PAIN. 

same  events,  so  far  as  the  visual  images  are  con- 
cerned. Hence,  begin,  at  the  very  moment  of  the 
happening  of  any  acts,  preparations  for  radical  di- 
vergences of  statements  (all  equally  truthful,  so  far 
as  the  intentions  are  concerned),  concerning  facts, 
thus  rendering  human  testimony  unreliable  unless 
we  subject  every  statement  of  fact  to  careful  analysis. 
Thus  with  ordinary  evidence  of  the  senses.  It  will 
be  seen,  when  we  come  to  consider  subjective  sen- 
sations, that  human  testimony,  growing  out  of  sub- 
jective states,  is  still  more  untrustworthy. 

The  disposition  abides  in  every  one  to  perceive 
only  that  which  the  attention,  for  many  reasons  of 
accident,  temperament  and  circumstance,  fastens  on 
and  is  occupied  by,  to  the  exclusion  of  all  things 
else. 

I  read  somewhere  this  relation:  an  eminent  sur- 
geon was  called  to  see  a  patient,  not  far  from  Lon- 
don, in  consultation  with  the  family  doctor.  The 
gentleman  had  two  daughters  who  waited,  in  much 
anxiety,  for  the  result  of  the  professional  examina- 
tion. At  last  the  surgeon  came  into  the  room 
where  the  family  were  waiting,  with  this  remark: 
44  Your  father  is  very  ill  and  he  is  not  likely  to  per- 
manently recover  from  his  disease.  But  he  will  get 
much  better,  will  be  comfortable  and  will  live  many 
years."  At  which  both  daughters  exclaimed  to- 
gether, the  one — "  The  Lord  have  mercy,  father 


SENSATION  AND    PAIN.  37 

will  die  !  "  and  the  other,  "  Thank  God,  father  will 
get  well,"  each  giving  attention  only  to  words  which 
suited  her  temperament  and  expectations.  It  is  pre- 
cisely the  same  in  occurrences  which  we  hear  and 
see  every  day  of  our  lives.  We,  consciously,  hear 
and  see  only  parts  of  what  actually  happens  and,  as 
we  have  already  pointed  out,  we  hear  and  see  imper- 
fectly that  which  we  hear  and  see  at  all.  And  the 
same  of  all  the  senses. 

That  sensation  which  rises  into  consciousness 
is  seldom  a  complete  representative  of  the  sen- 
sory impulse  which  is  the  occasion  of  the  per- 
ception. The  sensation  perceived  may  resemble, 
more  or  less  closely,  the  impulse  which  occa- 
sioned it,  or  it  may  have  no  recognizable  rela- 
tion to  the  original.  A  patient  called  at  my  of- 
fice, one  day,  in  a  state  of  great  excitement  from 
the  effects  of  an  offensive  odor  in  the  horse-car  she 
had  come  in,  and  which  she  declared  had  probably 
emanated  from  some  very  sick  person  who  must 
have  been  just  carried  in  it.  There  could  be  no 
doubt  that  something  had  affected  her  seriously 
for  she  was  very  pale,  with  nausea,  difficulty  in 
breathing  and  other  evidences  of  bodily  and  mental 
stress.  I  succeeded,  after  some  difficulty  and  time, 
in  quieting  her,  and  she  left,  protesting  that  the  smell 
was  unlike  anything  she  had  ever  before  experienced 
and  was  something  dreadful.  Leaving  my  office  soon 


38  SENSATION  AND    PAIN. 

after,  it  so  happened  that  I  found  her  at  the  street 
corner,  waiting  for  a  car:  we  thus  entered  the  car 
together.  She  immediately  called  my  attention  to 
the  same  sickening  odor  which  she  had  experienced 
in  the  other  car  and  began  to  be  affected  the  same 
as  before,  when  I  pointed  out  to  her  that  the  smell 
was  simply  that  which  always  emanates  from  the 
straw  which  has  been  in  stables.  She  quickly 
recognized  it  as  the  same,  when  the  unpleasant 
effects  which  arose  while  she  was  possessed  with  an- 
other perception  of  its  character,  at  once  passed  away. 
In  this  case,  we  may  say  that  the  sensation  which 
arose  into  consciousness  through  the  special  sense 
of  smell,  was  so  quickly  displaced  by  the  sensation 
which  arose  out  of  central  initiation  that  the  former 
was  not  recognized;  the  combination  of  sensations 
arising  out  of  the  cerebral  excitation  which  she 
could  only  name  as  something  very  bad,  taking  its 
place.  It  is  to  be  remarked  that  the  effect  in  con- 
sciousness was  precisely  the  same  as  if  there  had 
been  in  the  car  an  odor  of  the  character  which  she 
had  represented. 

I  select  another  instance  of  the  effect,  on  the 
senses,  of  previous  mental  impressions.  A  gentle- 
man, of  my  acquaintance,  ha'd  the  sight  of  the  right 
eye  nearly  destroyed  by  a  rapidly  formed  cataract. 
At  first  his  vision  was  seriously  impaired.  But, 
after  a  while,  he  found  that,  as  a  matter  of  habit, 


SENSATION  AND    PAIN.  39 

lie  always  endeavored  to  see  with  the  right  or  af- 
fected eye,  and  that,  whether  he  used  both  eyes  or 
only  the  affected  one,  his  vision  was  defective.  But, 
by  covering  the  unsound  eye,  he  could  see  perfectly. 
He  then  instituted  a  course  of  training  in  the  use  of 
.the  sound  eye,  and,  after  a  little  time,  he  could  see 
perfectly  while  using  both  eyes,  the  perfect  image 
formed  in  the  sound  eye  rising  in  consciousness  in- 
stead of  the  defective  image  of  the  unsound  eye. 
This  is  illustrated  in  the  following  experiment:  in 
looking  at  a  street  light,  several  blocks  away,  if 
he  covers  the  sound  eye,  he  can  see  only  a  thin 
crescent  of  light  at  the  upper  and  inside  border  of 
the  light,  the  larger  portion  being  covered  by  the 
darkness  of  the  opaque  portion  of  the  lense.  But 
when  after  thus  looking,  he  attempts  to  see  with 
both  eyes,  he  can  see  little  more  than  with  the 
unsound  eye.  But  when  he  covers  the  affected  eye, 
he  can  see  perfectly  well,  and  continues  to  see  per- 
fectly well  after  uncovering  the  unsound  eye,  the 
image  from  the  sound  eye  rising  into  consciousness 
when  the  impression  has  been  once  established.  In 
other  words,  this  gentleman  has  trained  his  brain 
to  take  the  impression  originating  in  the  sound  eye 
instead  of  that  received  from  the  unsound  eye.  That 
is  to  say,  he  has  either  a  perfect  or  an  imperfect  im- 
age in  his  mind  according  to  which  his  attention 
may  have  been  last  directed. 


40  SENSATION  AND    PAIN. 

While  a  vast  number  of  sensations  are  first  sug- 
gested or  at  least  receive  their  first  impulse  from 
peripheric  sources,  acting  through  one  or  more  of 
the  special  senses,  it  is  by  no  means  necessary  that 
this  should  be  the  case  at  all.  Centrally  initiated 
sensations  engage  by  far  the  greater  portion  of 
our  conscious  perceptions.  We  call  up,  alone  or 
in  various  combinations,  the  sensations  which  we 
have  previously  received  and  which  constitute 
our  previous  sensory  existence.  Each  sensation 
leaves  its  impression  in  the  very  constitution  of 
our  bodily  organism.  We  are  different,  after  re- 
ceiving certain  sensations,  from  what  we  would  be 
if  we  had  been  placed  in  different  circumstances  and 
had  received  other  sensations.  Not  only  this,  but 
we  may  use  our  stock  of  accumulated  sensations  in 
one  way  with  one  kind  and  degree  of  modifica- 
tion of  the  original  sensations,  or  in  another  way 
with  another  kind  and  degree  of  modification  of  the 
same  sensations.  In  other  words,  we  can  modify 
ourselves. 

And  here  we  arrive  at  the  very  pith  and  marrow 
of  the  matter.  Up  to  a  certain  point  and  in  a  cer- 
tain degree  and  manner,  we  are  unquestionably  au- 
tomata. If  it  were  otherwise,  life  would  be  sim- 
ply impossible.  The  sensations  which  we  receive 
through  the  five  senses  set  a-going  certain  machin- 
ery, the  result  of  which  is  sensory  life,  as  certainly 


SENSATION  AND    PAIN.  4 1 

as  the  opened  valve  lets  in  the  steam  which  makes 
the  ponderous  engine  throb  with  motion  and  power. 
But  steam,  having  once  been  used,  flows  out  lifeless, 
a  simple  waste.  Not  so  the  sensations.  Once  re- 
ceived, they  are  never  wholly  spent,  but,  in  various 
forms,  remain  as  a  portion  of  our  vital  selves,  so 
long  as  we  live.  And,  once  received,  we  may  use 
and  control  their  accumulated  substance,  much  as 
we  will.  The  reflexes  should  also  be  under  the  con- 
trol of  the  central  forces:  of  the  will.  Let  me  illus- 
trate how  this  is  not  always  the  case.  As  I  write, 
a  patient  relates  her  experience  as  follows:  on  a  cer- 
tain time  she,  with  other  members  of  her  family, 
was  out  in  the  garden  watching  the  Northern  Lights 
which  were  very  beautiful  that  evening.  She  said 
that  they  seemed  to  radiate  from  a  certain  centre  and 
passed,  in  long  waves  and  lines  of  light,  into  the 
more  distant  parts  of  the  heavens.  And  while  she 
was  standing  there  she  felt  the  electricity  streaking 
down  her  back  and  prickling  all  over  her,  until,  fi- 
nally, she  had  to  go  in.  Of  course,  there  was  no  elec- 
tricity and  the  sensations  suggested  by  the  lines  of 
light,  rapidly  forming  and  dispersing,  were  purely 
subjective.  I  do  not  call  them  imaginary,  in  any 
correct  use  of  that  word.  Unquestionably,  the  feel- 
ing excited  by  the  occasion,  amounted  to  ebullitions 
or  explosions  and  discharges  of  force  in  the  cerebral 
nerve-centres,  which  were  sufficient  to  arise  in  con- 


42  SENSATION  AND    PAIN. 

sciousness,  and  these  centrally  induced  sensations 
were  referred,  as  all  feelings  are  apt  to  be,  to  the 
periphery.  Having  a  feeling,  it  is  given  a  location, 
and,  frequently,  especially  with  undisciplined  minds, 
it  is  given  a  name  also.  And  it  is  curious  how  sel- 
dom the  names  given  to  these  centrally  initiated 
feelings,  represent  any  previous  experience  of  the 
individual.  The  statement  that  she  felt  electrical 
currents  coursing  down  her  back,  expressed  the  un- 
known rather  than  any  previous  experience.  The 
most  diverse  sensations  are  as  frequently  described 
as  electrical;  and  I  have  often  inquired  whether  the 
person  so  describing  had  ever  had  electricity  ap- 
plied to  her,  and,  in  many  cases,  I  find  that  she  had 
not.  Other  expressions  are  even  more  frequently 
used  to  express  centrally  initiated  sensations.  For 
instance,  a  lady,  the  other  day  said  that  her  head 
felt  as  if  there  was  a  vacuum  in  it.  And  another 
that  she  had  a  sensation  in  her  throat  as  if  water  was 
flowing  up  through  it.  Indeed,  the  flowing  of  water 
down  the  back  is  a  very  favorite  form  of  expressing 
sensations  which  cannot  be  compared  to  anything 
whatever.  Feeling  as  if  she  was  paralyzed  is  an- 
other favorite  expression,  used  by  persons  who  are 
especially  liable  to  centrally  excited  ebullitions  of 
energy  by  self-induced  sensations. 

Let  us  go  back  a  little  and  again  consider  what 
" centrally  excited  sensations"  are,  psychologically 


SENSATION  AND    PAIN.  43 

speaking.  They  are  the  memories  of  previous  ob- 
jective sensations.  They  are  sensations  which  have 
been  registered  and  are  re-excited  from  within. 
They  are  the  products  of  nerve-centres  which  have 
been  permanently  impressed  by  previous  sensations 
from  without.  They  are  the  combined  tracts  of  all 
one's  previous  experience.  They  are  traces  of  every 
sensation  which  has  gone  before,  rising  to  conscious- 
ness. They  are  the  results,  in  consciousness,  of 
pulses  of  nerve-centres  which  are  not  complete  ex- 
ponents of  any  single  or  definite  sensory  impulse  or 
combination  of  definite  sensory  impulses;  but  they 
are  likely  to  be  indefinite  and  wholly  unreliable,  un- 
stable and  shadowy  memories  of  a  vast  number  of 
previous  sensations,  arising  into  consciousness,  un- 
der the  stimulus  of  mental  conditions,  and  should 
be  so  considered.  Professor  Alexander  Bain  says: 
"  Our  knowledge  begins  with  difference;  we  do  not 
know  anything  of  itself,  but  only  the  difference  be- 
tween it  and  another  thing."  Some  one  else  has 
said  that  "culture  consists  in  increasing  the  power 
to  see  differences;  and  he  is  most  highly  cultivated 
who  sees  most  differences."  The  first  thing  which 
any  one  claiming  mental  culture  should  see  is  the  dif- 
ference between  objective  and  subjective  sensations. 
In  fact,  the  ability  to  appreciate  this  difference 
constitutes,  mainly,  the  broad  distinction  between 
education — the  possession  of  facts  and  ideas — and 


44  SENSATION  AND    PAIN. 

culture,  which  is  the  ability  to  properly  use  them. 
We  must  always  be  on  guard  against  confounding 
the  sensations  which  proceed  from  stimuli  acting 
from  without  and  those  cerebral  pulses  which  are  set 
up  within.  The  danger  is  so  great,  that  it  is  mar- 
vellous that  so  few  seem  to  realize  that  the  evidence 
of  their  feelings  is  not  to  be  taken  without  careful 
questioning.  If  the  direct  evidence  of  our  special 
senses  cannot  be  depended  on,  as  previously  shown, 
how  much  greater  must  be  the  liability  to  error 
when  conclusions  are  drawn  from  feelings  depend- 
ing on  those  pulses  of  nerve-force  which  have  been 
set  up  in  the  cerebral  end  of  the  nervous  system. 
And  yet,  large  numbers  of  people  take  the  evidence 
of  their  feelings,  having  nothing  but  an  emotional 
origin,  as  evidence  of  bodily  conditions.  And  the 
most  serious  part  of  it  is  that  they  also  interpret  the 
assumed  evidence  of  their  feelings  by  another  set  of 
emotional  ebullitions.  So  that  there  are  many  per- 
sons whose  ideas  of  their  bodily  conditions  are  the 
results  of  double  pulses  of  centrally  excited  nerve- 
centres.  An  emotional  temperament  is  simply  one 
in  which  the  pulse  of  action  in  the  nerve-centres, 
rises  higher  than  the  occasion  requires.  There  is  a 
throb  or  explosion  of  energy  under  a  stimulus  which 
would  produce  only  a  pulse,  in  ordinary  persons. 

^Esthetic  education,  especially  when  not  accom- 
panied with  special  discipline,  tends  to  increase  in- 


SENSATION   AND    PAIN. 


45 


herited  habits  until  the  existence  of  some  persons 
consists  of  successions  of  nerve-centre  explosions — 
with  all  the  prodigal  waste  of  energy  which  accom- 
panies that  state — where  mere  pulses  would  answer 
much  better.  Such  a  person  is  thrown  into  ecsta- 
sies of  pleasure  or  pain  by  causes  by  which  a  bal- 
anced temperament  would  not  be  affected.  If  a  lady, 
she  has  a  large  variety  of  feelings,  many  of  them 
disagreeable;  and,  if,  for  any  reason,  her  attention 
becomes  engaged  with  them,  it  is  apt  to  become  ab- 
sorbed in  their  contemplation.  If  she  has  feelings 
along  the  back,  she  concludes  she  has  spinal  dis- 
ease. If  it  is  the  head  which  disturbs  her — and  why 
should  it  not,  with  regular  batteries  of  nerve-centre 
explosions,  touched  off  by  her  own  untrained  and 
rampant  emotions — she  thinks  there  must  be  brain 
disease  or  something  horrible  there;  the  more  horri- 
ble in  name  the  better  it  will  suit  the  particular 
ebullition  which  names  the  disease.  There  is  sel- 
dom inquiry  concerning  the  symptoms  of  spinal 
disease  or  brain  disease;  the  inference  being  wholly 
subjective,  the  correspondence  of  symptoms  to  the 
disease  named  is  not  at  all  necessary. 

There  are  multitudes  of  people  in  whom  the 
centrally  initiated  sensations  far  exceed  in  number 
and  violence  those  which  arise  from  external  causes. 
Such  persons  live  under  continual  deception  of  their 
senses:  that  is,  they  have  sensations  which  are  as- 


46  SENSATION  AND    PAIN. 

sumed  to  arise  from  peripheric  sensory  impulses,  but 
which  are  mainly  or  wholly  subjective  explosions  of 
energy,  excited  to  action  from  within. 

Educated  persons  should  treat  such  sensations 
precisely  as  they  do  all  other  sensations— subject 
them  to  the  crucible  of  question  and  analysis. 
When  the  young  African  walks  forth  at  noon-day 
and  sees  an  object  following  him  which  he  does  not 
understand,  we  do  not  so  much  wonder  that  he,  in 
his  blind  ignorance,  conceives  his  shadow  to  be  a 
spirit  of  good  or  evil.  And  it  will  be  good  or  evil 
according  as  some  equally  simple  but  to  him  incom- 
prehensible, previous  influence  may  have  biased  his 
mind.  But  for  people,  living  in  civilized  communi- 
ties, to  accept  mere  mental  impressions  and  treat 
them  as  unquestioned  facts,  would  seem  incredible 
on  any  other  than  the  true  theory  that  we  are  not 
very  much  civilized,  after  all.  For  the  whole  su- 
perstructure of  the  belief  in  the  supernatural,  the 
marvellous  and  the  impossible  consists  in  such  ac- 
ceptance of  mere  impressions  in  the  place  of  facts, 
We  see  this  credulity  in  regard  to  everything,  espe- 
cially when  feelings  are  excited.  But  I  speak  more 
especially  with  reference  to  bodily  conditions.  And, 
happily,  my  personal  experience  covers  an  especially 
interesting  class  of  cases,  a  class  in  which  the  error 
of  accepting  mental  impressions,  as  evidence  of 
bodily  conditions,  is  well  marked  and  easily  dif- 


SENSATION  AND    PAIN.  47 

ferentiated.  And  I  give  it  as  the  result  of  a  good 
deal  of  carefully  guarded  experience  that  there  are 
hundreds  of  lame  people  walking  about  perfectly, 
who  do  not  know  that  they  ought  to  limp;  and  that 
there  is  a  much  larger  number  of  persons  who  are 
either  limping,  walking  on  crutches  or  not  walking 
at  all,  who  have  no  affection  whatever,  causing 
lameness.  For  it  is  not  the  fact  of  a  diseased  joint, 
which,  as  a  rule,  causes  lameness;  but  the  degree 
of  consciousness  of  an  affected  joint,  which  causes 
a  person  to  favor  it.  And  strange  as  it  may  appear 
to  those  who  have  no  experience  in  such  matters,  it 
is  not  every  one  with  a  diseased  joint  who  knows 
he  is  lame  and  favors  it  by  limping.  It  continually 
comes  under  my  professional  observation,  that  cer- 
tain persons  do  not  seem  to  be  conscious  of  an 
amount  of  disease,  in  a  joint  or  elsewhere,  which  is 
sometimes  capable,  unless  relieved,  of  causing  loss 
of  life.  While  others  became  hyper-conscious  of  the 
least  variation  from  the  normal  state.  And  even 
when  there  is  no  disease  whatever,  there  may  be  the 
feeling  of  disease,  in  consciousness.  A  young  lady  of 
seventeen  came  to  me  about  ten  years  ago  for  what 
she  and  her  friends  supposed  was  disease  of  the  hip 
joint.  After  examination,  I  told  her  that  there  was 
no  disease  of  the  joint  whatever.  I  tried  to  ex- 
plain to  her  comprehension  that,  for  some  reason, 
she  had  become  anxious  about  the  hip  joint,  and 


48  SENSATION  AND    PAIN. 

that  her  attention  was  so  fixed  on  it  that  all 
sensations  transmitted  from  that  vicinity  caused 
such  throbs  of  the  nerve-centres  that  an  ordinary 
sensation  was  converted  into  an  extraordinary  one; 
and  the  anxious  attention  which  she  directed  to 
that  part,  made  her  painfully  conscious  of  what 
would,  otherwise,  be  normal  sensations  and  thus 
unnoticed.  But  I  failed  to  impress  her  sufficiently 
to  divert  her  attention  from  the  part,  and  she  con- 
tinued to  walk  on  crutches,  in  all,  during  eight  years. 
At  last  she  suddenly  found  that  she  was  not  lame. 
I  had  the  pleasure  of  examining  her,  about  six 
months  after  she  had  ascertained  that  she  was  not 
lame  and  I  found  a  wholly  unaffected  joint,  precisely 
as  it  was  seven  years  previously  when  I  first  saw  her. 
In  this  case,  as  in  all  others  of  a  like  nature,  the 
difficulty  is  to  be  found  in  that  condition  of  the 
cerebral  nerve-centres  which  makes  an  ordinary 
sensory  impulse  to  cause  a  throb  of  change  in  the 
nerve-cells,  which  resembles,  in  consciousness,  what 
might  occur  from  an  extraordinary  sensory  im- 
pulse; as  from  a  joint  which  is  actually  diseased. 
As  the  excessive  action  within  the  nerve-cells  was 
due  to  subjective  and  controllable  causes,  the  only 
possible  remedy  lay  in  disciplining  the  emotions. 
The  study  of  the  relations  of  attention  to  con- 
sciousness and  perception,  is  so  important,  and  an 
understanding  of  those  relations  explains  so  many 


SENSATION  AND    PAIN.  49 

things  which  would,  otherwise,  seem  inexplicable, 
that  I  must  add  some  further  remarks  and  illustra- 
tions regarding  them. 

The  principal  point,  which  it  is  necessary  to  keep 
before  the  mind,  is  that  we  perceive  or  become  con- 
scious of  events  in  a  greater  or  a  lesser  degree,  or 
not  at  all,  according  as  the  attention  may  be  fixed 
on  that  or  on  something  else.  I  cannot  better  il- 
lustrate my  meaning  than  by  relating  a  story  which 
was  told  by  my  father,  many  years  ago. 

A  gentleman  went  to  the  bank  for  a  large  sum  of 
money.  Receiving  it,  he  put  it  in  his  pocket  and 
placing  his  hand  in  the  same  pocket,  directly  on  the 
package  of  money,  went,  as  rapidly  as  he  could  walk, 
to  his  own  office;  but  when  he  arrived,  he  found,  to 
his  astonishment,  that  the  money  had  disappeared. 
Questioned  by  the  detectives,  who  were  immediately 
called,  he  declared  most  positively  that  his  hand 
had  been  upon  the  money  every  moment  from  the 
time  he  left  the  bank  until  he  reached  his  own  office. 
The  thief  having  been  caught  with  the  money  on  him, 
and  confronted  with  the  gentleman,  the  latter  agreed 
not  to  prosecute  (so  the  story  goes)  if  he  would  tell 
him  how  he  got  it  while  his  hand  was  on  it.  "  Noth- 
ing could  be  more  easy,"  replied  the  thief,  "the  po- 
sition of  your  hand  indicated  where  the  money  was. 
Your  very  intent  to  protect  it  so  occupied  your 
mind  that,  when  I  tickled  your  ear  with  a  feather, 


50  SENSATION  AND    PAIN. 

you  did  not  know  that  you  withdrew  your  hand  to 
brush  away  what  you  supposed  was  a  fly.  Your  very 
earnestness  in  struggling  through  the  crowd,  your 
rapid  pace,  and  determination  to  convey  the  money 
safely,  all  were  aids  in  holding  your  attention  in  the 
grasp  of  a  vice,  so  that,  after  two  or  three  efforts,  I 
succeed-ed  in  extracting  the  money  from  your  pock- 
et, as  your  hand  was  withdrawn.  But  so  fully  was 
your  attention  taken  up  with  one  idea  that  you  did 
not  even  recognize  the  difference,  after  the  money 
was  gone.  And  that  is  the  way  I  did  it.  It  was 
with  your  own  unconscious  assistance." 

This  little  story  not  only  illustrates  the  office  of 
attention  in  relation  to  consciousness,  but  it  shows 
how  very  easy  it  is  to  be  mistaken  concerning  mat- 
ters about  which  men  are  apt  to  be  most  positive. 
And,  as  in  the  story  just  told,  nothing  contributes 
so  much  to  our  deception,  many  times,  as  our  own 
efforts,  when  they  have  not  been  previously  trained 
in  the  same  direction,  to  avoid  deception.  This  is 
also  abundantly  illustrated  in  the  case  of  inexperi- 
enced persons  when  attempting  to  fathom  the  sup- 
posed mysteries  of  so-called  Spiritualism,  Necro- 
mancy, and  other  proclaimed  supernatural  events. 

Without  attention  there  can  be  no  consciousness. 
It  is  true  that,  in  most  cases,  an  ordinary  sensory 
impulse  is  sufficient  to  arouse  consciousness  and  per- 
the  effect, "in  consciousness,  of 


SENSATION  AND    PAIN.  51 

a  sensory  impulse  is  in  the  direct  ratio  of  the  atten- 
tion in  that  direction,  and  in  the  inverse  ratio  of  the 
attention  engaged  in  other  directions.  This  is  as 
true  of  centrally  as  of  peripherally  excited  sensa- 
tions. Sir  John  Hunter  said  that  he  could  produce 
a  pain  in  his  finger  by  thinking  of  it:  that  is,  by 
merely  giving  his  attention  to  his  finger,  to  the  ex- 
clusion of  everything  else,  for  the  time  being.  My 
own  experience  satisfies  me  that  such  things  more 
frequently  happen  than  is  generally  supposed.  My 
friend,  Dr.  Lewis  Fisher,  on  returning  from  the 
country,  several  years  ago,  remarked  to  me  that 
he  had  recommended  a  case  to  me,  of  a  gentleman 
with  an  injured  knee,  who  had  consulted  him,  dur- 
ing the  summer.  At  the  time  Dr.  Fisher  saw  him 
there  was  some  inflammation  and  swelling  of  the 
knee,  for  which  he  had  prescribed;  recommending, 
at  the  same  time,  the  gentleman  to  apply  to  me 
for  further  treatment.  He  did  so  two  or  three 
months  later,  remarking  that  he  had  arranged  his 
business  so  that  he  could  remain  in  New  York 
during  the  winter  and  that  he  should  be  perfect- 
ly satisfied  if  he  could  resume  his  business  in  the 
following  spring.  He  had  been  injured  during 
the  preceding  winter,  along  with  several  others,  in 
coasting.  He  had  been  severely  cut  about  the  groin, 
which  was  supposed  to  be  the  extent  of  his  injuries. 
But  after  six  weeks'  confinement  and  recovery  from 


52  SENSATION  AND    PAIN. 

the  more  obvious  injury,  it  was  found  that  the  knee 
had  also  been  injured — concerning  which7  he  had 
sought  Dr.  Fisher's  advice.  He  walked  with  some 
difficulty  and  said  he  felt  pain  at  each  step.  On 
examination,  I  found  that,  in  the  mean  time,  the 
knee  had  entirely  recovered.  By  applying  sufficient 
tests,  I  soon  satisfied  him  that  there  was  neither  in- 
flammation, soreness  nor  stiffness  at  the  knee  joint. 
In  fact  that  it  was  perfectly  well.  Relieving  him 
of  his  apprehensions — simply  a  form  of  attention — 
he  no  longer  felt  any  pain  and  he  could  walk  just 
as  well  as  he  ever  could.  In  fact,  he  left  for  home 
within  less  than  an  hour  after  he  had  informed  me 
that  he  had  come  to  stay  for  the  winter.  The  in- 
jury had  necessarily  fastened  his  mind  on  the  af- 
fected knee;  but  the  interesting  although  common 
fact  is  that  he  could  not  distinguish  between  sensa- 
tions which  were  objective,  while  the  inflammation 
remained  in  the  joint,  and  the  sensations  which  were 
subjective,  after  the  disease  had  ceased  to  exist. 
Apprehension  served  to  keep  attention  riveted  to 
the  part  about  which  he  was  anxious,  and  this  fact 
kept  up  such  an  excitable  condition  of  the  nerve- 
centres  that  they  were  sent  off  into  continual  ebul- 
litions of  energy,  which  rose  in  consciousness  as 
pains  and  seemed  to  be  continuous  with  those  at- 
tending the  inflammatory  stage. 

This   case   (which    represents   a    large   family  of 


SENSATION  AND    PAIN.*  53 

similar  cases)  illustrates  a  remark  previously  made, 
that  we  do  not  remember  pain  as  we  do  ordinary 
sensations.  The  condition  producing  pain  ceases 
with  its  cure.  Hence  we  can  remember  only  the 
fact  and  circumstance  of  the  event.  The  memory 
of  the  actual  pain  ceases  to  be  possible  with  the 
cessation  of  the  pain  itself.  But  objective  pain 
may  call  up  or  be  the  occasion  for  those  subjec- 
tive conditions  which  are  constantly  mistaken,  in 
consciousness,  for  real  pains.  Thus  we  may  have 
the  objectively  caused  pains  diminishing  gradually 
with  progress  towards  recovery  from  a  condition 
producing  pain,  while  there  may  be  a  gradually 
increasing  subjective  state  which,  in  consciousness, 
resembles  pain,  but  which  is  really  a  memory  of  the 
circumstances  of  pain  heightened  by  the  habit  of 
the  cerebral  nerve-centres  to  be  thrown  into  ex- 
cessive action,  which  I  have  already  dwelt  upon. 
In  such  cases,  the  patient  finds  it  impossible  to 
distinguish  between  the  objectively  caused  pain, 
the  product  of  disease,  and  the  subjective  state,  re- 
sembling pain  in  consciousness,  which  is  wholly  due 
to  what  may  now,  for  convenience,  be  termed  emo- 
tional pain.  And  it  is  the  work  of  attention,  in  its 
various  forms  of  self-observation,  anxiety  and  alarm, 
(especially  in  certain  temperaments)  to  establish 
conditions  favoring  emotional  pains.  The  only  pos- 
sible cure  for  such  pseudo-pains  is  the  direction  of 


54  SENSATION  AND    PAIN. 

attention  away  from  the  feelings  which  tend  to  de- 
velop them.  This  is  done  very  effectually,  some- 
times, by  empirical  practices,  which,  as  may  be  in- 
ferred, do,  so  far  as  changing  the  subjects  occupying 
the  person's  attention  may  go,  have  a  scientific 
basis.  The  difficulty  is  that  a  disease  is  supposed 
to  be  cured,  whereas  the  subjects  occupying  the  at- 
tention in  the  form  of  fear,  anxiety,  apprehension, 
etc.,  have  been  changed.  It  is  something  which  is 
constantly  done  by  every  intelligent  doctor;  though, 
it  must  be  admitted  that,  not  to  claim  mysterious 
power,  divests*  the  honorable  practitioner  of  a  large 
portion  of  his  means  of  controlling  the  attention 
which  quacks  possess,  in  a  certain  class  of  subjects, 
because  of  their  pretensions. 

It  is  astonishing  how  completely  the  attention 
can  be  occupied  under  favorable  conditions.  A  gen- 
tleman told  me  that  he  happened  to  be  on  a  visit  to 
the  army  when  the  battle  of  Williamsburg  took 
place.  In  endeavoring  to  pass  in  the  rear  of  the 
forces  engaged,  he  met  a  soldier  who  inquired  the 
way  to  a  certain  regiment.  Stopping  to  give  him 
the  necessary  information,  he  observed  that  one 
hand  had  been  shot  away.  But  when  he  called  the 
soldier's  attention  to  it  he  at  first  denied  it  and  it 
was  only  by  insisting  that  he  should  look  for  his 
hand,  that  he  became  aware  of  the  injury.  Here 
was  an  amputation,  without  anaesthetics  and  with- 


SENSATION  AND    PAIN.  55 

out  conscious  pain,  by  the  mere  absorption  of  the 
attention  in  the  progress  of  the  battle  around  him. 
It  is  said  to  be  the  same  very  generally  in  sharp  en- 
gagements: the  participants  are  often  oblivious  to 
their  injuries  and  only  recognize  them  by  results — 
the  dripping  blood,  the  failing  strength,  etc.  On 
the  other  hand,  cases  like  that  given  by  Dr.  Bennett, 
and  that  of  Boutibonne,  as  given  by  Noble,  and 
quoted  by  Tuke,  are  innumerable.  A  butcher,  in 
trying  to  hang  up  a  heavy  piece  of  meat,  slipped  and 
was  suspended  on  the  hook.  He  suffered  great 
agony  when  taken  down  and  on  being  carried  to  the 
chemist  his  sleeve  had  to  be  cut  away,  because  of 
the  pain.  But  it  was  found  that  the  hook  had  only 
penetrated  his  sleeve,  the  arm  being  uninjured.  The 
story  of  Boutibonne  is  still  more  curious.  It  was 
at  the  battle  of  Wagram  and  men  were  falling  all 
around  him  when  he  felt  both  his  legs  carried  away 
by  a  cannon-shot.  He  sank  down  about  eighteen 
inches  and  fell  back  benumbed  by  the  shock.  Hav- 
ing been  told  that  hemorrhage  was  lessened  by  quiet- 
ude, he  remained  perfectly  still  until  the  next  morn- 
ing, when  the  surgeons  coming  around,  it  was  found 
that,  instead  of  the  legs  having  been  shot  away,  the 
cannon-ball  had  ploughed  a  deep  hole  in  the  earth 
beneath  his  feet  into  which  he  had  sunk,  and  that 
he  was  entirely  unhurt.  The  number  of  like  in- 
stances which  might  be  quoted  is  unlimited. 


56  SENSATION  AND    PAIN. 

Now  these  are  not  merely  curious  instances  of  ex- 
ceptional perversions  of  sensations;  but  they  repre- 
sent extreme  examples  of  phenomena  which,  in 
various  forms,  are  common  to  all  human  beings. 
And  very  practical  use  can  be  made  of  the  fact  that 
sensations,  of  whatever  kind,  are  not  only  mental 
but  depend,  for  force  and  quality,  on  the  actual  pres- 
ent state  of  the  mind.  I  remember  a  lesson  that  was 
taught  me  very  early  in  my  practice,  which  I  have 
never  forgotten  and  which  has  been  of  great  value 
to  me.  It  happened  that  I  had  a  patient  whose 
uncle  was  a  surgeon  of  some  eminence.  There  was 
occasion  to  perform  a  relatively  small  operation 
and,  out  of  courtesy,  I  invited  the  uncle  to  do  it. 
The  patient  was  a  feeble  nervous  little  fellow,  and 
between  the  mother's  sobs  and  the  uncle's  rough- 
ness, the  child  was  wrought  up  into  a  frenzy  of  ex- 
citement not  only  painful  to  witness  but  causing 
considerable  loss  of  valuable  time.  It  occurred  to 
me  that  a  better  use  of  the  time  could  be  made 
in  preparing  patients,  mentally,  for  an  operation. 
And  this  is  what  I  have  ever  since  done.  So  effec- 
tive has  the  mental  management  of  patients  been, 
in  my  experience,  that  I  long  since  discarded  the 
use  of  anaesthetics  in  the  minor  operations,  such  as 
tenotomy,  opening  of  abscesses  and  the  like,  except 
in  rare  cases  of  badly  spoiled  children.  One  of  the 
first  cases  on  which  I  operated  after  the  experience 


SENSATION  AND    PAIN.  57 

above  related,  was  that  of  a  babe,  only  twenty-two 
months  old — not  old  enough  to  understand  lan- 
guage— so  that  I  was  obliged  to  control  him  by 
tones  of  voice  and  management.  In  the  first  place, 
no  one  was  allowed  to  caress  him  or  in  any  manner 
excite  any  form  of  emotion  immediately  preceding 
the  operation,  which  was  for  club  foot.  Then  the 
attendants  were  not  only  instructed  but  actually 
trained  in  modulating  their  voices  to  a  quiet,  sooth- 
ing cadence.  Every  one  was  required  to  move 
carefully;  and  patience,  as  if  we  had  weeks  at  our 
disposal,  was  strictly  enjoined.  The  result  was  that 
there  was  scarcely  an  outcry  at  the  cutting  of 
the  tendon.  There  was  little  calculated  to  fasten 
the  attention  on  the  foot  as  the  seat  or  on  me  as  the 
cause  of  the  pain.  So  that  when  I  returned,  the  next 
day,  he  held  out  his  foot  for  me  to  inspect,  as  if  noth- 
ing had  happened.  Taught  by  this  experience,  I 
have,  ever  since,  made  it  a  point  to  always  regulate 
the  mental  condition,  before  an  operation,  and  have 
found  that,  in  the  majority  of  cases,  minor  opera- 
tions can  be  done  with  little  pain  and  with  no  men- 
tal suffering  whatever.  In  the  first  place,  it  is  often 
necessary  to  eliminate  or  neutralize  the  influence  of 
parents,  in  exciting  their  children's  feelings,  in  re- 
sponse to  their  own  emotions;  which  is  not  always 
an  easy  thing  to  do.  To  excite  a  child's  emotions, 
by  endearing  words,  caressings,  presents  and  prom- 


58  SENSATION  AND    PAIN. 

ises,  toys  and  sweetmeats,  is  rather  worse  than  a 
whipping  as  a  preparation  to  bear  an  operation.  But 
worse  than  anything  else,  is  the  deception  which  is 
so  frequently  practised  on  people,  and  especially  on 
children,  in  reference  to  an  operation.  They  always 
discount  what  is  told  them  at  a  heavy  percentage 
and  their  fears  are  excited  generally  far  beyond  the 
real  occasion.  There  is  but  one  way  to  treat  a  pa- 
tient, and  especially  a  child,  and  that  is  the  manly 
way.  If  an  operation  will  hurt,  tell  him  so,  no  mat- 
ter how  young  he  may  be.  Justify  his  confidence  in 
you  by  always  speaking  the  truth.  This  will  allay 
fear  and  he  will  approach  quite  a  serious  operation 
without  anxiety  or  alarm.  As  a  rule,  children  so 
managed,  will  express  astonishment  at  the  small 
amount  of  pain  experienced.  "Why,"  they  often 
say,  "  I  thought  it  would  hurt  more.  I  don't  care." 
Analysis  of  these  procedures,  shows  that  they 
are  calculated  to  lessen  the  fixity  of  the  patient's 
attention,  and  thus  they  actually  lessen  the  pain 
which  would,  otherwise,  attend  an  operation.  For 
more  than  twenty  years  I  have  practised  the  men- 
tal anaesthetics — if  I  may  be  allowed  the  expression, 
— and  I  am  positive  that  a  physician,  by  careful  man- 
agement to  that  end,  can  diminish  the  actual  pain 
and  general  suffering  of  patients,  in  proportion  as 
such  management  is  calculated  to  eliminate  uncer- 
tainty, and  thus  enable  the  patient  to  "make  his 


SENSATION  AND    PAIN.  59 

mind  up"  to  a  definite  conception  through  reason 
alone  with  small  influence  of  emotion.  And  the 
best  means  he  can  possibly  bring  to  bear  is,  in  my 
opinion,  to  always  speak  the  truth,  the  whole  truth 
and  nothing  but  the  truth,  under  all  possible  cir- 
cumstances of  bodily  ailment. 

Recurring  to  the  difficulty  of  distinguishing  be- 
tween objective  and  subjective  sensations,  I  will  re- 
mark upon  the  physiological  reality  of  both,  and 
especially  that  a  knowledge  of  the  fact  that  a  sen- 
sation is  rising  in  consciousness  without  the  object, 
does  not  necessarily  prevent  the  occurrence  of  such 
a  sensation.  The  most  that  such  knowledge  can  do 
is  to  prevent  the  deception  of  our  judgments.  The 
mental  images — which  are  continually  forming  in  all 
minds,  visual  and  auditory,  most  frequently — are 
only  feebler  forms  of  the  visions  which  some  persons 
frequently  and  many  persons  occasionally  have.  The 
works  of  writers  on  mental  phenomena  abound  in 
striking  illustrations  of  these  forms  of  purely  subjec- 
tive construction.  They  are  a  part  of  our  daily 
mental  life.  As  illustrating  the  fact,  above  alluded 
to,  that  we  cannot  prevent  them,  even  when  rec- 
ognizing their  non-objective  origin,  perhaps  I  cannot 
do  better  than  to  relate  an  incident  which  happened 
to  myself,  many  years  ago. 

It  is  thirty  years,  since — for  reasons  which  it  would 
not  interest  you  to  relate — I  found  myself,  one  night, 


60  SENSATION  AND    PAIN. 

alone  in  the  middle  of  one  of  the  then  almost  un- 
broken prairies  of  western  Illinois. 

After  some  hours'  wandering,  I  realized  that  I  had 
lost  my  way.  I  was  accustomed  to  crossing  and  re- 
crossing  the  prairies,  and  such  a  feeling  as  fear  never 
entered  my  mind.  The  worst  that  could  happen, 
was  to  remain  on  the  prairie  till  morning.  But  my 
wife  expected  me;  my  young  wife,  who  had  left  her 
home  in  the  east  and  had  gone  with  me  to  what 
was  then  the  "far  West,"  would  be  anxious  about 
me.  Hence  the  excited  feeling  which  was  the  pre- 
paration for  events  which  followed.  In  her  anxiety 
I  thought  she  would  divine  the  cause  of  my  delay 
and  would  send  the  sons  of  the  gentleman,  at  whose 
house  we  stopped, — two  stalwart  western  fellows — 
in  search  of  me.  I  reasoned,  what  could  be  more 
certain  ?  Then  I  listened.  There  was  not  a  sound 
to  break  the  utter  deadness  of  the  night  air.  Not 
an  insect  stirred;  not  a  rustle  of  a  wild-flower's  leaf 
smote  the  waiting  ear.  Then  there  was  a  sound. 
Yes,  I  was  right,  the  Ward  boys  were  looking  for 
me.  And  as  I  listened,  never  was  sound  of  gallop- 
ing horse  more  distinct.  Galloping  horse?  Why, 
there  were  two  horses,  with  their  riders.  Then  the 
sound  died  out.  They  must  be  crossing  a  stream. 
Yes.  They  come  up  on  the  hither  side  and  are  com- 
ing nearer.  So  I  go  back  to  meet  them.  But  the 
sound  dies  away.  Have  they  missed  the  track  ?  No, 


SENSATION  AND    PAIN.  6 1 

for  at  brief  intervals  I  hear  them  as  before.  Now 
nearer,  now  further  away.  Now  at  shorter  and 
shorter  intervals  and  with  more  and  more  vary- 
ing discrepancies  until  the  thought  arose  that  my 
senses  had  deceived  me.  So  I  began  testing,  as  well 
as  I  could,  the  sense  of  hearing.  And  I  found,  even 
there,  under  the  peculiar  circumstances,  I  could  hear 
galloping  horses  in  any  direction,  by  simply  turn- 
ing my  attention  and  strongly  wishing  to  hear  that 
sound.  That  matter  settled,  I  pursued  my  way,  un- 
der the  expectation,  that,  by  going  on  I  must  come 
to  a  settlement.  For,  though  still  thinly  settled, 
the  country  was  filling  up  rapidly  and  houses  would 
spring  up,  as  if  by  magic,  and  farms  were  being  put 
under  fence  and  plough,  in  all  directions.  To  my 
relief,  about  midnight,  the  moon  came  up,  right  in 
front  of  me.  By  its  light. I  could  see  the  grove  of 
timber  which  had  been  my  objective  point  lying  far 
to  the  left  and  rear.  It  was  too  far,  I  thought,  to 
turn  back  now.  I  would  keep  on,  find  a  house  (I 
reasoned  that  I  had  gone  about  far  enough  for  that) 
and  get  directions  for  reaching  my  destination  by  a 
shorter  way.  And  there  lay,  right  in  front  and  a 
little  to  the  right,  a  newly  made  farm  fence.  It  had 
been  put  directly  across  the  travelled  road,  causing 
the  latter  to  make  a  detour  to  the  left  to  avoid  it. 
That  must  be  a  New  England  man,  said  I  to  myself, 
no  western  man  makes  so  well-ridered  a  fence  as  that. 


62  SENSATION  AND    PAIN. 

But,  as  I  approached  it  so  that  I  could  distinguish 
the  different  rails  and  many  things  in  detail,  I  was 
surprised  when  it  suddenly  vanished  from  before  my 
very  eyes.  And  it  did  not  return  as  the  sounds  of 
galloping  horses  had  done.  Was  it  possible,  I  ques- 
tioned, that  my  senses  had  again  deceived  me,  not- 
withstanding, warned  by  the  previous  experience, 
I  had  put  myself  on  my  guard  ?  But  so  it  was. 
There  was  no  sign  of  fence  or  other  evidence  of 
human  activity.  And,  relieved  that  this  second 
experience  had  effectually  cured  me  of  any  future 
sense-deception,  I  travelled  on.  By  this  time  the 
light  from  the  moon  was  sufficient  to  make  my  road 
and  everything  plain,  as  I  went  towards  the  new 
settlement,  to  which  the  road  I  had  taken  must 
certainly  lead.  It  was  a  new  road,  as  the  easily 
destroyed  prairie  vegetation  clearly  indicated,  and 
must  terminate  in  that  cluster  of  small  board  houses, 
which  the  increasing  light  of  the  moon  and  my  nearer 
approach,  enabled  me  to  distinctly  see.  This  time 
there  wras  no  mistake.  It  was  a  scattered  settle- 
ment of  some  half  a  dozen  houses,  recently  put  up, 
as  yet  without  fenced  fields  or  even  land  ploughed 
in  anticipation  of  next  year's  crop.  Selecting  the 
one  nearest  and  a  little  to  the  left,  situated  on  a 
slight  elevation,  I  made  my  way  towards  it.  I  would 
inquire  the  way,  borrow  a  saddle,  for  greater  ex- 
pedition to  relieve  a  watching  wife,  and  return,  next 


SENSATION  AND    PAIN.  63 

day,  for  the  wagon.  A  light  in  the  house,  and  at 
this  hour !  There  must  be  sickness,  I  feared.  Not 
to  disturb  them,  I  left  my  horse  standing  in  the  road 
and,  bounding  up  the  slight  acclivity,  I  was  almost 
reaching  out  my  hand  for  the  door-latch,  when  I 
saw — a  scrub  oak-tree,  with  a  star  shining  through 
its  branches !  And  the  new  settlement  which  my 
excited  brain  had  built  and  peopled,  had  vanished ! 
How  I  retraced  my  weary  steps;  how  I  arrived,  to- 
wards morning  and  awakened  a  calmly  sleeping  wife 
and  family,  need  not  be  related. 

It  requires  but  a  slight  exercise  of  the  faculty  of 
analysis  to  discover  that  the  main  elements  in  the 
production  of  a  conscious  sensation  of  hearing  and 
seeing  things  which  had  no  objective  or  real  exist- 
ence, a  certain  degree  of  cerebral  excitement,  ac- 
companied by  a  certain  degree  of  concentrated 
attention,  was  all  that  was  necessary,  and,  these 
conditions  the  occasion  supplied  in  proper  quantities. 
It  may  be  pertinent  to  inquire  here,  in  passing,  what 
more  do  we  have  in  so-called  Mesmerism,  Hypno- 
tism, Spiritual  manifestations  and  Trance,  than 
simply  more  extreme  instances  of  concentrated 
attention,  with  its  accompanying  special  cerebra- 
tion ?  As  the  experience,  just  related  shows,  it  is 
not  sufficient  to  prevent  subjective  sensations  from 
rising  in  consciousness  as  representatives  of  objective 
sensations,  to  know  that  they  are  not  objective. 


64  SENSATION  AND    PAIN. 

Given  concentration  enough,  and  enough  suscepti- 
bility to  the  subjective  influence,  and  the  images 
may  arise  in  consciousness,  all  the  same  notwith- 
standing we  know  their  origin.  It  is  often  difficult 
and  sometimes  impossible  to  distinguish,  in  con- 
sciousness, between  the  one  and  the  other.  No  one 
is  to  be  blamed  for  being  thus  deceived,  unless  he 
determines  that  he  will  not  take  the  means  for  veri- 
fying and  correcting  his  impressions.  And  this  is 
the  conclusion  to  which  we  must  come.  It  is  not 
that  we  shall  never  be  mistaken,  in  regard  to  things 
which  we  see  and  hear,  or  which  we  suppose  we  see 
and  hear;  but  the  lesson  we  should  learn  is  that  we 
must  always  be  on  our  guard  against  mistakes  and 
suspend  judgment,  be  slow  to  conclusions,  until  we 
have  had  time  to  compare  one  sensation  in  con- 
sciousness with  another  sensation  in  consciousness, 
as  well  as  for  the  nerve-centres  to  subside  from  what 
may  be  ebullitions  or  explosions  of  energy,  obscur- 
ing the  judgment,  to  more  quiet  pulses  of  action, 
which  give  time  and  a  better  basis  for  accurate 
conclusions. 

It  is  a  neglect  of  such  precautions,  as  I  have  just 
referred  to,  among  the  masses,  that  makes  them 
peculiarly  liable  to  be  deceived  by  their  own  sen- 
sations, variously  acted  on,  and  renders  them  so 
prone  to  fall  willing  victims  to  charletans,  who  are 
themselves  sometimes  equally  self-deceived. 


SENSATION  AND    PAIN.  65 

Among  plain  people  what  more  simple,  than  to 
conclude,  if  one  has  a  pain  and  another  lays  his 
hand  over  the  place,  and  the  pain  disappears,  that 
there  has  been  some  virtue  passing  from  the  hand 
to  the  part  affected  ?  There  was  the  pain,  the  hand 
and  the  non-pain.  A  little  analysis  shows  how 
complicated  such  an  apparently  simple  matter  may 
be.  In  the  first  place,  there  may  be  no  cause  of 
pain  at  the  point  referred  to  by  the  consciousness. 
A  patient  of  mine,  who  lost  his  arm  in  the  war,  often 
feels  pain  in  his  fingers.  That  is,  there  is  a  throb  ot 
change  in  his  nerve-centres  similar  to  what  he  ex- 
perienced when  he  used  to  hurt  his  fingers.  So  his 
fingers  are  referred  to,  in  consciousness,  as  the 
source  of  the  sensation.  As  he  has  no  fingers,  from 
which  such  a  sensation  could  arise,  the  conscious- 
ness is  clearly  mistaken.  Or,  suppose  one  has  fin- 
gers and  that  some  condition  in  them  causes  pain. 
As  pain  is  a  matter  of  consciousness,  he  will  not  have 
pain  if  his  attention  is  sufficiently  preoccupied. 
For  we  cannot  be  conscious  of  two  feelings  at  the 
same  time.  That  is,  the  attention  will  be  occupied 
by  whatever  sensation,  whether  objective  or  subjec- 
tive, may  be,  for  the  moment,  paramount.  But  a 
person,  professing  or  believing  himself  endowed 
with  power  of  healing,  is  very  likely  to  engage  a 
patient's  attention,  to  the  exclusion  of  even  a  sense 
of  pain,  in  certain  cases.  Hence  the  supposed  re- 


66  SENSATION  AND    PAIN. 

markable  powers  of  healing  we  hear  of.  The  same 
faith  (which  is  but  another  form  of  fixed  atten- 
tion) may  exist  with  reference  to  medicines  or 
anything  else,  occupying  the  attention,  to  the 
exclusion  of  the  unpleasant  sensation  which  pre- 
ceded it.  The  thing  done  will  thus  pass  for  a 
curative  means,  when  it  simply  changes  the  objects 
of  contemplation.  This  may  be  temporary,  or  in 
some  cases,  it  is  more  or  less  permanent,  during 
which  time  the  local  condition  may  change  for  the 
better  or  worse,  quite  independently  of  the  conscious 
feelings  regarding  the  part.  And  I  do  not  deny  that 
a  change  of  attention  may  exert  and  influence  fa- 
vorably to  the  establishment  of  a  better  condition. 
On  the  other  hand,  concentrating  the  attention  upon 
certain  parts,  where  certain  diseases  are,  without 
proper  discrimination,  wrongly  assumed  to  be  lo- 
cated, the  running  to  doctors,  of  whatever  kind, 
good  or  bad,  the  getting  so  easily  "  cured  "  by  each 
new  remedy  or  new  doctor,  is  well  calculated  to 
demoralize  a  person  both  mentally  and  bodily,  and 
be  the  cause  of  actual  sickness. 

As  an  illustration  of  the  ease  with  which  an  indi- 
vidual, and  even  a  certain  number  in  a  community, 
may  mistake  appearances  for  realities,  the  following 
narrative  is  presented.  About  ten  years  ago  I  first 
heard  of  the  alleged  remarkable  skill  of  an  Italian 
peasant  woman.  Among  others  I  was  told  of  the 


SENSATION  AND    PAIN.  67 

reduction  of  a  dislocated  hip  joint  in  the  case  of  a 
regular  physician  of  this  city,  which,  it  was  asserted, 
had  practically  cured  him  of  a  serious  lameness 
which  had  afflicted  him  for  many  years.  During  the 
following  year,  I  was  visited  by  a  near  relative  of 
this  gentleman  who  partly  confirmed  the  extent  of 
the  relief  which  had  been  afforded.  Being  curious 
to  see  for  myself,  I  sent  the  gentleman  an  invitation 
to  call  on  me,  for  the  purpose  of  allowing  me  to 
make  an  examination.  A  few  days  afterwards,  he 
very  kindly  called  and  freely  and  with  perfect  frank- 
ness related  his  experiences  as  follows:  He  said  he 
had  had  dislocation  of  the  right  hip  joint  for  twenty- 
seven  years,  or  since  he  was  a  child.  His  leg  was 
so  drawn  up  and  shortened  that  he  had  been  obliged 
to  wear  a  very  high  patten  which,  since  his  visit  to 
Italy,  he  had  been  able  to  dispense  with.  He  said 
that  the  process  was  this:  after  some  dkys  of  appli- 
cations of  a  kind  of  poultice  to  the  hip,  he  had  been 
laid  on  his  back,  on  a  table,  when  he  was  seized  by 
the  leg  and  knee  and,  by  a  dexterous  but  entirely 
painless  movement,  the  dislocated  bone  was  restored 
to  its  socket,  and  the  limb  brought  down  beside  the 
other.  When  she  commanded  him  to  look  at  his 
feet,  he  saw,  to  his  inexpressible  delight,  the  feet 
beside  each  other,  for  the  first  time  since  his  re- 
membrance. Leaping  from  the  operating  tabl^,  he 
found  he  could  walk  with  an  ea#e"  a^^mfort:  vHikifo/./> 

//  vVW      N>sS^v^'lr//r//^/<//       ^ 

X^s^ip&-:  ,J'<&J' 
\    JL1I~  _bc'^  Ix< 

>  ^^^^^ 


68  SENSATION  AND    PAIN. 

he  had  never  before  experienced.  His  gratitude 
knew  no  bounds.  Out  of  a  sense  of  benevolent  duty 
he  had  already  taken  several  parties  to  Italy,  all  of 
whom  had  been  substantially  benefited  by  her  mar- 
vellous skill.  At  my  request,  he  submitted  to  an 
examination  by  Dr.  T.  M.  L.  Chrystie  and  Dr.  Wil- 
liam R.  Fisher,  who  were  in  my  office,  and  myself. 
The  result  of  our  examination  revealed  three  facts; 
viz.:  first,  that  the  joint  could  not  have  been  dis- 
located; for,  second,  it  was  firmly  fixed  (anchylosed) 
in  the  socket,  and  must  have  been  so  all  the  time; 
and,  third,  the  union  was  with  the  thigh  at  about  a 
right  angle,  so  that  there  could  not  possibly  have 
been  any  change,  in  position,  at  the  time  of  the  so- 
called  "  operation." 

Now,  it  is  not  necessary  to  doubt  the  good  faith 
and  absolute  sincerity,  of  either  patient  or  peasant, 
in  order  to  comprehend  how  a  mistake  could  come 
about  of  supposing  that  something  had  been  accom- 
plished when,  in  reality,  no  change,  whatever,  had 
been  effected.  It  may  be  asked,  "  How  do  I  know 
that  I  was  not  mistaken?"  It  can  be  very  easily 
demonstrated  that  I  was  not.  I  laid  the  gentleman 
on  a  table,  and,  without  the  least  difficulty,  and  with 
no  dexterity  at  all,  I  brought  the  foot  of  the  affected 
side  down  beside  the  other;  as  is  seen  in  Fig.  7. 


SENSATION  AND    PAIN. 


69 


Fig.  7. 


A  person  with  the  right  hip  joint  immovably  fixed,  at  about 
a  right  angle  with  the  pelvi's,  who  believes  motion  has 
been  restored  to  the  joint  by  the  manipulations  of  a  char- 
latan :  showing  how,  when  lying,  he  brings  his  feet  to- 
gether by  tilting  forwards  the  pelvis  and  bending  his 
back  upwards,  he,  meantime,  supposing  the  motion  is  at 
the  hip  joint. 

But  as  you  will  also  see  in  the  same  figure,  to  do  it, 
I  had  to  tilt  the  pelvis  forward  so  as  to  curve  the  lum- 
bar spinal  column  in  a  very  large  arch,  as  the  fig- 
ure shows.  But  when  I  attempted  to  bring  the 
lower  portion  of  the  spinal  column  in  contact  with 
the  table,  I  found  it  impossible  to  do  so  or  to 
move  it  in  the  least  degree  in  that  direction,  un- 
less the  thigh  came  up,  in  a  corresponding  degree 
and  into  nearly  the  vertical  position,  when  he  lay 
without  any  curve  in  the  back,  as  is  shown  in  Fig. 
8.  The  same  thing  was  true  in  his  standing  and 


SENSATION  AND   PAIN. 


Fig.  8. 


Same  as  preceding  figure,  and  shows  that,  when  his  back 
rests  naturally  on  the  couch,  the  limb  is  drawn  upwards, 
which  would  not  be  the  case,  if  there  were  motion  at  that 
joint. 

walking  positions  and  movements.  Under  the  im- 
pression that  the  position  and  use  of  the  hip  joint 
had  been  restored,  he  had  discarded  the  patten  which 
he  had  previously  worn  (to  compensate  for  the  short- 
ening of  the  affected  limb)  and  he  then  progressed 
in  this  peculiar  manner:  At  times  (evidently  when 
his  attention  was  on  it)  he  would  reach  the  lame  foot 
to  the  ground  by  an  evident  effort,  but  always  with 
the  same  extreme  forward  curve  in  the  lower  part 
of  the  back  to  which  I  have  alluded.  (Fig.  9.)  At 


SENSATION  AND    PAIN. 

Fig.  9. 


The  same  as  figure  7,  but  in  the  standing  position.     The  po- 
sition is  maintained  by  an  effort  of  the  will. 

other  times  (as  when  his  attention  was  not  engaged), 
his  back  would  partly  straighten,  and  then  his  knee 
would  be  drawn  up  and  he  would  reach  the  ground 
by  bending  the  knee  of  the  well  limb.  (Fig.  10.) 


7?  SENSATION   AND    PAIN. 

Fig.    IO. 


The  same  person,  as  he  walks  when  his  attention  is  diverted, 
by  bending  the  knee,  of  the  unaffected  limb,  till  the  foot  on 
the  side  of  the  rigid  joint  reaches  the  ground. 

It  maybe  asked,  "How  do  you  account  for  such  a 
mistake  in  regard  to  the  position  of  one's  own  limb  ?" 
It  is  easy  enough,  if  we  assume  that,  with  his  atten- 
tion concentrated  on  the  position  of  his  feet,  he  did 


SENSATION   AND    PAIN.  73 

not  notice  that  the  pelvis  was  tilted,  in  the  man- 
ner described,  in  order  to  bring  the  feet  together.* 
Likewise,  under  the  excitement  of  a  supposed  change 
of  position  in  the  joint,  he  failed  to  consider  (possi- 
bly did  not  know)  that  such  a  limb  can  always  be 
placed  beside  the  other  by  simply  tilting  the  pelvis 
forward  enough.  All  his  movements  afterwards  took 
place  under  the  impression  that  an  alteration  had 
been  effected  in  the  position  of  his  limb,  with  the 
effect  on  his  locomotion,  above  described. 

As  this  case  has  been  widely  published  and  often 
referred  to,  during  nine  or  ten  years  past,  I  do  not 
hesitate  to  relate  the  facts  of  which  I  have  personal 
knowledge,  as  one  of  the  best  possible  illustrations 
of  the  purely  subjective  character  of  a  certain  class 
of  cases,  and  the  reasons  why  intelligent  persons 
may  have  positive  convictions  concerning  them- 
selves which  are  not  in  accord  with  the  facts. 

There  are  two  classes  of  persons  who  furnish  the 
principal  subjects  for  so-called,  "  bone-setters  " — a 
class  of  persons  which,  like  mesmerizers,  mediums, 
necromancers,  etc.,  could  not  exist  except  for  the 
plentiful  number  of  people  who  accept  the  evidence 
of  their  senses,  without  question. 

They  consist  of  those  persons  who,  like  the  case 
above  related,  are  affected  in  some  way,  and  after 

*  In  cases  of  anchylosis  of  one  hip  joint,  the  lower  portion  of  the  spinal 
column  becomes  very  flexible. 


74  SENSATION   AND    PAIN. 

certain  manipulations,  suppose  themselves  bene- 
fited, when  they  are  not.  And  a  still  more  numer- 
ous class  who  believe  themselves  affected  with  a 
disease  or  lameness,  when  they  are  not  so  affected. 
In  both  cases,  they  accept  the  evidence  of  their  sen- 
sations and  suppose  that  they  are  better  because 
they  are  made  to  feel  different.  The  self-deception 
is  readily  explainable.  The  cerebral  nerve-centres 
are  acted  powerfully  on,  mainly  through  emotional 
attention,  expectant  attention,  curiosity,  hope  and 
other  forms  of  attention,  until  the  feelings  of  which 
the  mind  was  previously  conscious,  whether  objec- 
tive or  subjective,  are  displaced  and  superseded  by 
the  newly  acquired  feelings.  The  person  has  ac- 
quired certain  sensations  which  are  pleasant,  in 
consciousness,  displacing  others  which  were  disa- 
greeable. Hence,  he  thinks  himself  cured.  That 
the  affection  which  he  had  or  supposed  he  had, 
has  been  benefited,  is  a  mere  conclusion. 

And  allow  me  here  to  say  that  I  think  it  would 
better  comport  with  the  dignity  of  my  own  profes- 
sion, if  physicians  would  take  a  more  philosophical 
view  of  such  facts  as  I  have  related,  and,  instead  of 
being  annoyed,  should  study  to  know  the  philosophy 
of  delusions  of  every  kind.  It  will  thus  be  found  that 
the  cause  lies  deep  in  the  nature  of  sensory  ex- 
istence, and  that  the  remedy  can  be  found  only 
*n  a  higher  culture,  which  must  include  a  better 


SENSATION  AND    PAIN.  75 

knowledge  of  what  really  constitutes  sensation  and 
pain. 

The  central  ideas,  in  the  foregoing  presentation, 
maybe  summarized  as  follows:  Conscious  sensation, 
whether  objective  or  subjective,  is  a  mental  act.  A 
sensory  impulse  becomes  a  conscious  sensation 
only  by  producing  a  display  of  energy  in  the  cere- 
bral nerve-centres,  or  brain,  of  a  certain,  or  cogniza- 
ble degree  of  force;  and  then  only  when  the  atten- 
tion is  not  engaged  with  other  relatively  paramount 
sensations.  Attention,  occupied  with  one  sensa- 
tion, excludes  other  sensations,  while  thus  occupied. 
Single  sensations  give  no  knowledge,  whatever, 
of  objects  acting  on  the  senses.  Multiplied  sen- 
sations leave  traces  which  are  recognized,  in  con- 
sciousness, as  belonging  to  the  same  or  to  differ- 
ent or  to  compounded  sensations ;  and,  hence, 
there  is  formed  the  sense-judgment,  or  conclusion, 
a  memory  identifying  or  comparing  one  sensation 
with  those  which  have  preceded  it.  Hence,  sen- 
sations, except  the  first,  are  never  single,  but  are 
always  compounded  of  those  exciting  and  those 
which  are  excited.  At  first,  the  primary  or  excit- 
ing sensations  are  objective,  the  responding  ones, 
subjective.  But  soon  the  faculty  of  subjectively 
exciting  other  subjective  sensations,  is  acquired; 
when  perception  becomes  still  more  complicated, 
and  liable  to  error.  There  is  no  way  of  distinguish- 


76  SENSATION  AND    PAIN. 

ing  between  objective  and  subjective  sensations, 
except  through  an  act  of  the  reason:  which  is  an- 
other way  of  saying,  that  we  must  wait  before  al- 
lowing a  conclusion  to  be  formed.  A  hasty  judg- 
ment, in  regard  to  any  feeling,  is  likely  to  be 
erroneous.  Pain  is  different  from  ordinary  sensa- 
tion in  that  it  requires  an  abnormal  condition  for 
its  production,  and  that  it  cannot  be  produced  with- 
out such  abnormal  condition.  Hence,  it  is  impos- 
sible to  remember  pain,  because  the  apparatus  does 
not  exist  for  causing  such  a  sensation  as  pain,  after 
the  fact,  or  when  it  is  to  be  remembered.  Memory 
is  a  repetition,  in  the  nerve-centre  of  energy  which 
was  first  caused  by  the  sensory  impulse  from  with- 
out. But  centrally  initiated  sensations  may  be  mis- 
taken, in  consciousness,  for  pains;  depending  wholly 
on  a  certain  intensity  of  excitability  in  the  cerebral 
mass.  But  here  again  reason,  or  slowness  in  arriv- 
ing at  conclusions,  is  able  to  differentiate  between 
actual  and  mistaken  pains,  and  thus  to  resolve  the 
latter  out  of  existence. 

The  savage  or  primitive  man,  accepts  the  evidence 
of  his  senses  in  all  things,  without  question.  The 
first  step,  in  man's  progress  upward,  is  the  begin- 
ning of  questioning.  To  recognize  one's  limitations 
is  to  over-leap  them.  And  the  highest  evidence  of 
culture  and  progress  is  to  be  able  to  suspend  judg- 


SENSATION  AND    PAIN.  77 

ment  regarding  every  thought  and  feeling,  while 
submitting  them  to  the  arbitrament  of  unbiased 
examination. 


NOTE.  The  following  authors  were  consulted  be- 
fore preparing  the  foregoing  paper:  Carpenter,  Bain, 
Herbert  Spencer,  Bastian,  Maudsley,  Tuke,  Huxley^ 
Galton,  Dalton,  Orton,  McCosh  and  Noah  Porter. 


Handy-Books  for  every  Household. 

The  Maintenance  of  Health.  By  J.  MILNER  FOTHER- 
GILL,  M.  D.  A  Medical  Work  for  Lay  Readers.  I2mo, 
cloth, $2  oo 

"  The  most  important  book  of  its  kind  that  has  ever  been  published 
in  this  country." — Christian  Union. 

11  The  most  complete  summary  of  this  subject  of  general  hygiene  that 
we  have  ever  seen,"—  N.  Y.  Nation. 

The    Mother's    Work    with    Sick    Children.      By 

Prof.  J.  B.  FONSSAGRIVES,  M.D.  Translated  and  edited 
by  F.  P.  FOSTER,  M.D.  A  volume  full  of  the  most  prac- 
tical advice  and  suggestions  for  mothers  and  nurses. 

121110,  cloth, $i  oo 

"  A  volume  which  should  be  in  the  hands  of  every  mother  in  the 
land."  — Bingh  am  to  n  Hera  Id. 

A  Manual  of  Nursing.  Prepared  under  the  direction  of 
the  Training  School  for  Nurses,  Bellevue  Hospital. 
1 8 mo,  boards,  .  .  .  ,  .  .75  cents. 

ik  The  directions  are  quite  full  and  clear  for  all  the  essential  details  of 
the  service.  The  compiler  has  embodied  in  the  work  the  combined  ex- 
perience of  the  medical  profession  and  the  most  intelligent  experts,  and 
the  result  is  a  hand-book  better  adapted  to  render  the  nurse  a  faithful 
and  efficient  co-operator  with  the  physician  than  any  previous  manual 
of  the  kind  we  have  seen." — Home  Journal. 

Emergencies,  and  How  to  Meet  Them.  Compiled 
by  BURT  G.  WILDER,  Professor  of  Physiology  and 
Comparative  Anatomy  in  Cornell  University.  321110, 
sewed, .  .15  cents. 

The  Blessed  Bees.  An  account  of  practical  Bee-keeping, 
and  the  author's  success  in  the  same.  By  JOHN  ALLEN. 
i6mo,  cloth, $i  oo 

*  *  *  "  The  record  of  a  year's  intelligent  experience  in  the  care  of 
bees  and  the  gathering  of  honey.  Tt  was  a  year  of  great  success  in  the 
author's  case,  and  with  clearness,  interest,  and  practical  details  he  gives 
the  processes  and  results  in  these  pages.  If  others  would  do  half  so 
well  in  the  work  of  bee  culture,  there  would  be  a  great  multitude  to 
rise  up  and  call  the  bees  blessed." — N.  Y.  Observer. 

Hand-book  of  Statistics   of  the  United   States. 

A  Record  of  the  Administrations  and  Events  from  the 
organization  of  the  United  States  Government  to  the 
present  time.  Comprising  brief  biographical  data  of  the 
Presidents,  Cabinet  Officers,  the  Signers  of  the  Declaration 
of  Independence,  and  Members  of  the  Continental  Con- 
gress ;  Statements  of  Finances  under  each  Administration, 
and  other  valuable  material.  I2mo,  cloth,  ,  .  $i  oo 


th: 


u  The  book  is  of  so  comprehensive  a  character  and  so  compact  a  form 
lat  it  is  especially  valuable  to  the  journalist  or  student.  "--.W.  Y.  World, 


Handy-Books  for  every  Household. 

'Till  the  Doctor  Comes,  and  How  to  Help  Him. 

By  GEORGE  H.  HOPE,  M.D.  Revised,  with  Additions 
by  a  New  York  Physician.  ***  A  popular  guide  in 
all  cases  of  accident  and  sudden  illness.  I2mo, 
cloth,  ...  .  .  .  .  75  cents. 

"  A  most  admirable  treatise  ;  short,  concise,  and  practical."—  Har- 
per s  Monthly  (Editorial). 

"  We  find  this  an  invaluable  little  compendium,  embracing  more  in- 
formation of  use  to  bystanders  in  time  of  sickness  or  accident  than  we 
have  ever  seen  put  together  before.  If  one  will  study  this  small  book 
well,  put  it  in  his  pocket,  and  follow  its  directions  carefully,  he  will 
often  save  some  poor  fellow's  life,  when  a  little  delay  might  cause  its 
loss."— Athol  Transcript. 

"  A  perfect  gem  for  the  sick-room,  and  should  be  in  every  family."— 
Venango  Spectator. 

"  Indispensable  for  the  household/'— Utica  Herald. 

How  to  Educate  Yourself.  A  complete  Guide  for 
Students  showing  how  to  study,  what  to  study,  and  how 
and  what  to  read.  It  is,  in  short,  a  "Pocket  School- 
master." By  GEORGE  GARY  EGGLESTON.  i2mo, 
boards,  .......  50  cents. 

"  We  write  with  unqualified  enthusiasm  about  the  work,  which  is 
untellably  good  and  for  good." — N.  Y.  Evening  Mail. 
"  We  cordially  commend  this  work." — N.  Y.  School  Journal. 

How  to  Make  a  Living.  By  GEORGE  GARY  EGGLES- 
TON, author  of  "  How  to  Educate  Yourself."  I2mo, 
boards,  .......  50  cents. 

"  Shrewd,  sound  and  entertaining."—  N.  Y.  Tribune. 
"  An  admirable  little  treatise,  full  of  sound  practical  advice." — Chris- 
tian Union. 

The  Home.     Where  It  Should  Be,  and  What  to 

Put  in  It,  Containing  Hints  for  the  selection  of  a 
Home,  its  Furniture  and  internal  arrangemeuts,  with 
carefully  prepared  price  lists  of  nearly  everything  needed 
by  a  housekeeper,  and  numerous  valuable  suggestions  for 
saving  money  and  gaining  comfort.  By  FRANK  R. 
STOCKTON,  (of  Sciibner's  Monthly).  I2mo,  182  pages, 
cloth,  .......  75  cents. 

"  Young  housekeepers  will  be  especially  benefited,  and  all  house- 
keepers may  learn  much  from  this  book." — Albany  Journal. 

Infant  Diet.  By  A.  JACOBI,  M.D.,  Clinical  Professor 
of  Diseases  of  Children,  College  of  Physicians  and  Sur- 
geons, New  York.  Revised,  enlarged,  and  adapted  to 
popular  use,  by  MARY  PUTNAM  JACOBI,  M.D.  121110, 
boards,  .......  50  cents. 

"  Dr.  Jacobi's  rules  are  admirable  in  their  simplicity  and  comprenen 
siveness." — N.  Y.  Tribune. 


